[The significance of exogenous sodium uptake in the perioperative homeostasis of the water and electrolyte balance].
In 13 surgical patients who underwent abdominal surgery of moderate degree it has been shown that postoperative sodium substitution of normal range (1.5 m eq/kg bw. .24 h) led to hyponatremia and aldosteronism with Na+ and water retention. Aldosteronism was strongly correlated to increased activity of the renin-angiotensin-system, both anteceded by restriction of the extracellular space and expansion of total body water. These were controlled by a high sodium input (5 m eq/kg bw. .24 h) without changing the volume infusion, which is demonstrated by suppressed renin and aldosterone secretion rates, improved diuresis and subsequent reduction of total body water in favor of a preserved functional extracellular space. In order to avoid inadequate fluid redistribution it seems reasonable to meet the patient's postoperative sodium requirements by increased sodium input.
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000450:Aldosterone / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D001834:Body Water / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008875:Middle Aged; D011182:Postoperative Care; D011188:Potassium / Q000097:blood; D012083:Renin / Q000097:blood; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D012964:Sodium / Q000097:blood; D012965:Sodium Chloride / Q000008:administration & dosage*; D014882:Water-Electrolyte Balance / Q000187:drug effects*
D012462:Saline Solution, Hypertonic; D000804:Angiotensin II; D012965:Sodium Chloride; D000450:Aldosterone; D012964:Sodium; D012083:Renin; D011188:Potassium; D006854:Hydrocortisone
Die Bedeutung der exogenen Natriumzufuhr für die perioperative Homöostase des Wasser- und Elektrolythaushaltes.