Fluid and electrolyte control in simulated and actual spaceflight

Effects of microgravity on body fluid distribution and electrolyte and hormonal levels of astronauts have been studied since the early manned space missions. Bedrested subjects have been used as controls to separate effects of microgravity from those of hypokinesia. These investigations have led to documentation of the physiological effects of spaceflight and to a unified theory of response to microgravity. During flight, crewmembers have decreased thirst and a net loss of body water, sodium, and potassium. These changes seem to be initiated by passive transfer of extracellular fluid resulting in increased central venous pressure (CVP), to which the homeostatic mechanisms respond. A new equilibrium state is maintained during flight; it does not change in response to negative calcium and nitrogen balances during flight. On reexposure to gravity, profound water and salt retention occurs to replete extracellular fluid. Attempts to avoid cardiac deconditioning by repleting water and salt before leaving microgravity have somewhat ameliorated postural hypotension but have had little effect on CVP, cardiac chamber size or electrolyte dynamics.