J.Jpn. Surg. Soc.. 81(1): 1-14, 1980
Original article
STUDIES ON RED CELL KALIUM IN SURGICAL DISEASE
－ESPECIALLY ON SIGNIFICANCE OF G.I.K. THERAPY－
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First Department of Surgery, Fukushima Medical College (Director: Prof. Kenji Honda) Makoto Okano |
The results were as follows:
I. Preoperative value
1. The kalium value in the red cell (R-K value) was 130±12mEq/L in healthy persons and the patients who were in good condition in preoperative period.
2. The preoperative R-K value of 19 cases (1.6%) with dehydration or jaundice were under 118 mEq/L.
II. Changes of the R-K value after operation in 1155 cases
1. In 861 cases (74%), the R-K value kept the preoperative level and their postoperative courses were uneventful.
2. In 127 cases (11%), the changes of the R-K value were slight and recovered to the preoperative level without treatment soon. Their postoperative courses were uneventful.
3. In 84 cases (8%) operated upon before 1973, the R-K value decreased remarkably. In their cases, the postoperative complications had been overlooked.
4. In 83 cases (7%), various complications including cerebral symptom (delirium unconsciousness and coma), atrial fibrillation, intestinal paralysis developed.
5. Fourty six out of 83 cases with the complications were treated with administration of kalium intravenously or orally. The complications gradually disappered in a few weeks. The other 37 cases were treated with glucose, insulin and kalium (G.I.K. therapy) or with glucose and insulin (G.I. therapy) and the complications disappered within 12 to 24 hours.
III. The G.I. therapy was used in the patients whose serum kalium value was more than 5.5 mEq/L and consisted of an intravenous transfusion of glucose, 0.6 to 1.2 g/Kg, and regular insulin, 0.3 to 0.7 u/Kg. The G.I.K. therapy was used in the patients whose serum kalium level was between 3.0 to 5.5 mEq/L and consisted of an intravenous transfusion of glucose, 0.6 to 1.2 g/Kg, regular insulin, 0.3 to 0.7 u/Kg, and kalium, 0.3 to 0.8 mEq/Kg.
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