J.Jpn. Surg. Soc.. 54(1): 56-68, 1953

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Original article

Part 2. The exchange of electrolytes in the major surgical patients.

Fifty-one cases of the major surgical patients such as gastric carcinoma, gastro-duodenal ulcer, pulmonary tuberculosis etc. were studied on the metabolic exchange of sodium, chloride and potassium, water and salt balance, the change of extracellular fluid volume and circulating plasma volume, and discussed about these laboratory data.
In the cases of chronic and malignant disease, the preoperative serum concentration of sodium, chloride and potassium was generally low, and those of pyloric stenosis showed apparent dehydration.
It is noticable that the serum concentration was not parallel to the urinary output, so that the former could not indicate the postoperative salt supply in spite of the Van Slyke's conculusion, in which the urinary output of salt indicates far more apparently the grade of salt depletion than the serum concentration. The fluid volume by the postoperative gastric suction was seen less in the cases of gastric carcinoma than those of ulcer, and the electrolytes involved in it was variable, but the concentration of sodium and potassium became higher postoperatively. The estimation of the loss of these electrolytes is indispensable for the postoperative salt supply, and 6. 0 grams of salt was considered necessary for the treatment of cases, in which the fluid volume by gastric suction was daily more than 1,000cc.
Then, the relation between the fluid volume by gastric suction and the postoperative treatment, and the factor of potassium output were discussed, and in such as major surgical patients, the proper volume of water and salt for postoperative fluid therapy was determined.
(author's abstract)

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