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Moreover, the balance of each system is physiologically maintained through modification in the balance of the remainders. The complexity of clinical management is increased by the strict interconnection existing between electrolytes, acid-base system and fluid distributions: any change in one of them is responsible of modification of both the remainders. In these cases, the preservation of fluid, ionic, osmolar and acid-base balance is the sum of complex clinic evaluations and actions, taking into account the kind of surgery, the alterations due to anaesthesia, the effects of cardiopulmonary bypass, patient’s comorbidities and his own response to surgical stress. Maintaining electrolyte, acid-base and fluid balance is the final goal of any clinical treatment in the setting of cardiac surgery and in particular with the complex clinic of congenital heart diseases. The discovery of the unsuspected intrinsic ability of melanin to dissociate and reform water molecules, similar to the role of chlorophyll in plants, was confirmed in the study of ISF and CSF biology. The recent hypothesis based on glucose and ATP as sources of energy presents numerous contradictions and controversies. This aspect is the energy necessary to propel them properly in time, form, space, quantity and temporality. There is one aspect that has not been deeply analyzed, despite being prevalent in all the above processes, it is considered a part of the CSF and ISF dynamics. Anatomical principle of the barrier and routes of fluid transfer cannot explain the extraordinary accuracy of fluids and substances needed to enter or leave the brain firmly. Many hydrophilic substances are effectively prevented from the entry into the brain via blood, while others like neurotransmitters are extremely hindered from getting out of the brain. Despite this, CSF and ISF exhibit very similar compositions, but differ significantly from blood plasma. Microvessels within the parenchyma are sufficiently close to every cell where diffusion areas for solutes are tiny.
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The ISF and CSF provide water and solutes influx and efflux from cells to these targeted fluids in a quite precise way. This constitutes a formidable challenge that normal organisms surpass daily. The skull is a rigid box thereby the sum of volumes occupied by the parenchyma with its ISF, related connective tissue, the vasculature, the meninges and the CSF must be relatively constant according to the Monroe-Kellie dogma. The current view assumes that choroidal plexuses secrete the major part of Cerebrospinal Fluid (CSF), while the Blood-Brain Barrier (BBB) has a much less contribution to fluid production, generating Interstitial Fluid (ISF) that drains to CSF. There are specific mechanisms concerned with fluid secretion of the controlled composition of the brain, and others responsible for reabsorption eventually to blood and the extracellular fluid whatever their composition is.
Brain control of body fluid compartments free#
This regulation tends to act as barrier to prevent free exchange of materials between the brain and blood. These fluids transport all substances required for cells and remove the unwanted materials. Regulation of composition, volume and turnover of fluids surrounding the brain and damp cells is vital.
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The review concludes with some of the key challenges and opportunities faced by this next-generation wearable sensing technology. Successive content will focus on microneedle technologies which have been integrated with electrochemical biosensors for the quantification of various metabolites, electrolytes and other miscellaneous entities known to be present in the dermal interstitial fluid. We look briefly at microneedle technologies used to extract dermal interstitial fluid for subsequent analysis. An introduction to interstitial fluid is provided placing emphasis on sampling methods that have been employed to extract and/or sample tissue fluid for analysis. The integration of a biosensor with a microneedle platform opens the possibility for minimally invasive bio-chemical detection or continuous monitoring within the dermal interstitial fluid. This article explores recent advances in the development of electrochemical biosensors on microneedle platforms towards on-device sensing of biomarkers present in dermal interstitial fluid.