Carbohydrate or Electrolyte Rehydration Recovers Plasma Volume but Not Post-immersion Performance Compared to Water After Immersion Diuresis

• Published in: Military medicine Vol. 189; no. 7-8; pp. 1612 - 1620
• Main Authors: Wheelock, Courtney E, Lavoie, Elizabeth M, Stooks, Jocelyn, Schwob, Jacqueline, Hess, Hayden W, Pryor, Riana R, Hostler, David
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 03.07.2024
• Subjects: Adult; Carbohydrates; Diuresis - drug effects; Diuresis - physiology; Electrolytes; Electrolytes - analysis; Fluid Therapy - methods; Fluid Therapy - standards; Fluid Therapy - statistics & numerical data; Humans; Immersion - physiopathology; Male; Plasma Volume - physiology; Water
• ISSN: 0026-4075; 1930-613X; 1930-613X
• DOI: 10.1093/milmed/usad379

ABSTRACT Introduction We tested the hypothesis that a carbohydrate (CHO: 6.5%) or carbohydrate–electrolyte (CHO + E: 6.5% + 50 mmol/L NaCl) drink would better recover plasma volume (PV) and exercise performance compared to water (H2O) after immersion diuresis. Methods Twelve men (24 ± 2 years; 82.4 ± 15.5 kg; and V̇O2max: 49.8 ± 5.1 mL · kg−1 · min−1) completed four experimental visits: a no-immersion control (CON) and three 4-h cold-water (18.0 °C) immersion trials (H2O, CHO, and CHO + E) followed by exercise in a warm environment (30 °C, 50% relative humidity). The exercise was a 60-minute loaded march (20.4 kg; 55% VO2max) followed by a 10-minute intermittent running protocol. After immersion, subjects were rehydrated with 100% of body mass loss from immersion diuresis during the ruck march. PV is reported as a percent change after immersion, after the ruck march, and after the intermittent running protocol. The intermittent running protocol distance provided an index of exercise performance. Data are reported as mean ± SD. Results After immersion, body mass loss was 2.3 ± 0.7%, 2.3 ± 0.5%, and 2.3 ± 0.6% for H2O, CHO, and CHO + E. PV loss after immersion was 19.8 ± 8.5% in H2O, 18.2 ± 7.0% in CHO, and 13.9 ± 9.3% in CHO + E, which was reduced after the ruck march to 14.7 ± 4.7% (P = .13) in H2O, 8.8 ± 8.3% (P < .01) in CHO, and 4.4 ± 10.9% (P = .02) in CHO + E. The intermittent running protocol distance was 1.4 ± 0.1 km in CON, 1.4 ± 0.2 km in H2O, 1.4 ± 0.1 km in CHO, and 1.4 ± 0.2 km in CHO + E (P = .28). Conclusions Although CHO and CHO + E better restored PV after immersion, post-immersion exercise performance was not augmented compared to H2O, highlighting that fluid replacement following immersion diuresis should focus on restoring volume lost rather than fluid constituents.