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[The effect of various electrolyte solutions on the water and electrolyte balance during the postoperative phase].

Investigations with 3 electrolyte solutions having different qualitative and quantitative compositions were carried out to see their effect on the physiological equilibrium in the pre, intra- and postoperative phases in patients who had to undergo moderately severe surgery. On the basis of electrolyte and osmolarity determinations in serum and 24-hour urine, blood gas analyses, determinations of hemoglobin and hematocrit, 24-hour volume and specific weight of the urine, it was possible to establish an electrolyte administration adapted to the pre-, intra- and postoperative condition of the patients. By the infusion of a solution with this electrolyte content it was possible to keep the measured parameters within the normal range throughout the entire period of measurement before, during and after the operation.

Acid-Base Equilibrium

Oral salt supplements to compensate for jejunostomy losses: comparison of sodium chloride capsules, glucose electrolyte solution, and glucose polymer electrolyte solution.

Six patients with jejunostomies and residual jejunal lengths of 105 to 250 cm took the same food and water each day for eight study days. In random order, three methods of salt replacement were tested, each over 48 hours, against a period without added salt. During the three test periods the patients took 120 mmol of sodium chloride daily, as salt in gelatine capsules, as an isotonic glucose electrolyte (280 mOsmol/kg; 30 kcal) solution, and as a glucose polymer (Maxijul) solution (280 mOsmol/kg; 200 kcal). The daily stomal output remained constant for each patient during the four test periods but varied between patients from 0.60 to 2.84 kg (daily intestinal fluid balance 0.74-2.61 kg). Without a salt supplement, three patients lost more sodium from the stoma than they took in by mouth (-25, -94, and -101 mmol/day) and the mean sodium balance for all six subjects was -16 mmol (range -101 to 79) daily. Extra salt was absorbed with each form of supplement (p less than 0.05); no patient with the glucose electrolyte solution (mean 96, range 0 to 226 mmol), but one patient with the glucose-polymer solution (mean 96, range -25 to 164 mmol) and two with the salt capsules (mean 66, range -8 to 145 mmol) were in negative balance. Two patients vomited with the salt capsules. There was only a small increase in energy absorption (mean 115 kcal) with the glucose polymer solution compared with the glucose electrolyte solution. A sipped glucose electrolyte solution seems to be the optimal mode of sodium replacement in patients with a high output jejunostomy.

Adult

[Changes in serum electrolyte concentration and electrolyte excretion induced through infusion of glucose or glucose-exchange substances].

The metabolic effects of intravenous infusion of glucose, fructose, sorbitol or xylitol were investigated using human volunteers. The infusion period was 4 hours or 48 hours. Serum phosphate concentration decreased quickly and independent on the kind of the carbohydrate used. On the other hand, the serum concentration of potassium or sodium did not show any greater deviations from normal. Considering the renal excretion, greater differences between the single substances were seen. Renal potassium excretion was increased especially during xylitol infusions, and not as much during sorbitol infusions, as compared to infusions with glucose or with fructose. These differences were demonstrated especially for the first 12 hours of the infusions periond. During the infusions of glucose or of fructose an oral substitution of the electrolytes was suggicient. However, during xylitol infusions an intravenous substitution of potassium salts was necessary, despite the fact that the changes in serum concentration were only small. It is emphasized to carefully monitor serum electrolyte concentration and renal electrolyte excretion during long lasting intravenous infusions therapy.

Electrolytes

Serum electrolyte, mineral, and blood pH changes after phosphate enema, water enema, and electrolyte lavage solution enema for flexible sigmoidoscopy.

Hypertonic sodium phosphate (Fleet) enema is a commonly used preparation for fiberoptic flexible sigmoidoscopy. Unfortunately, Fleet has been associated with complications in children and adults. The purpose of this study was to compare the serum electrolytes, mineral, and blood pH changes before and after the administration of Fleet with water and polyethylene glycol electrolyte lavage solution (Golytely) as enemas in an adult population undergoing flexible sigmoidoscopy. Sixty-six patients were randomized in a double-blind fashion to receive two enemas of either Fleet (N = 22), water (N = 20), or Golytely (N = 24). The cleansing ability was graded from 1 to 4 (1 = poor, 4 = excellent). The Fleet had significantly better optimal cleansing efficacy compared with water (p < 0.05) but not to Golytely (p > 0.05). There was a significant increase in the serum phosphorus in the Fleet group compared with water (p < 0.001) or Golytely (p < 0.001). However, absolute serum phosphorus values after Fleet enema always remained within normal range in all but one patient. The changes in other electrolytes, minerals, and venous pH were insignificant.

Calcium

Electrolyte levels and net fluid and electrolyte movements in the gastrointestinal tract of weanling swine.

Electrolyte concentrations, osmolality and pH were determined in conventionally raised weanling swine fed a liquid diet. Incorporation of a dilution marker into the diet in combination with frequent feeding enabled estimations as to the sites of relative fluid and electrolyte absorption and secretion along the gastrointestinal tract. Unlike many other species the weanling pig depends largely on its large intestine for absorption of fluid and electrolytes with small changes in net fluid movement occurring along the jejunal and ileal segments. Additional observations included the absorption of water by the porcine stomach which increased dilution marker concentration by approximately twofold and the high osmolality values recorded in the small and large intestine. The implications of these observations are discussed with regard to pathogenesis of colibacillary diarrhea in the weanling pig.

Animals

Effect of propranolol on ricinoleic acid- and deoxycholic acid-induced changes of intestinal electrolyte movement and mucosal permeability. Evidence against the importance of altered permeability in the production of fluid and electrolyte accumulation.

Hydroxy fatty acids and bile acids produce both intestinal fluid and electrolyte accumulation and increases in inulin clearance, a parameter of mucosal permeability. The relationship of the changes in mucosal permeability to the production of fluid and electrolyte accumulation is uncertain. These experiments were designed to determine whether the alterations of mucosal permeability produced by ricinoleic acid and deoxycholic acid were related to production of hydroxy fatty acid- and bile acid-induced fluid and electrolyte accumulation in the rat colon. Propranolol (1 mg per 100 g of body weight) administered daily for 3 days inhibited ricinoleic acid- and deoxycholic acid-induced Na and water accumulation. In contrast, propranolol did not affect either the increase in inulin clearance or the decrease in electrical potential difference produced by ricinoleic acid and deoxycholic acid. Further, amphotericin B increased inulin clearance by the colon and also increased water and Na absorption. These studies suggest that changes in mucosal permeability are not primarily responsible for hydroxy fatty acid- and bile acid-induced fluid and Na accumulation.

Amphotericin B

[Variations of glucose, fructose, sorbite and electrolyte concentration following intravenous or intraperitoneal administration of sorbite-electrolyte solution to cattle and sheep].

Different quantities of sorbite-electrolyte solution were intravenously administered to eight heads of cattle and four heads of sheep (application values being 50 g sorbite, 0.3049 g MgCl2-6H2O, 0.3728 g KCl, 0.5477 g CaCl2-6H2O, 5.265 g NaCl, 6.804 g sodium acetate-3H2O with 1,000 ml distilled water). Different rises of sorbite, fructose, and glucose were recorded from the blood plasma. Certain manifestations of incompatibility and intolerance phenomena were observed, among them increase of cardiorespiratory activity and muscular tremor. Those findings were obtained primarily from animals which exhibited also strong rise in glucose concentration. One of the sheep died. Larger quantities of solution (2,000 ml or 4,000 ml) were intraperitoneally applied to ten heads of cattle and tolerated by them with no reaction. Sorbite in blood plasma usually reached its maximum two or three hours from application, however, without any rise of fructose or glucose. Slow drip infusion or intraperitoneal infusion are the techniques recommended for application of the above sorbite-electrolyte solution to ruminants.

Animals

[Changes in serum electrolyte concentration and in urinary electrolyte excretion during the infusion of glucose or glucose substitutes].

In groups of volunteers the concentration differences of phosphate potassium and sodium in serum were measured during 48-hour continuous infusion of glucose or glucose substitutes (fructose, sorbitol or xylitol). The dosage was 0.25 g/kg BW/hour. Additionally, the effect of fructose infusion in a dosage of 0.5 g/kg BW/hour was observed. Besides, the urinary excretion of sodium and of potassium was analysed. In contrast to short-term and high-dosed infusions of glucose or glucose substitutes, the phosphate concentration in serum was scarcely influenced. Only during high-dosed fructose infusion and during infusion of xylitol and sorbitol a small decrease in serum phosphate concentration was noticed. The effect of xylitol is pronounced. Additionally, the sodium concentration in serum was especially decreased during xylitol infusion. With regard to the sodium excretion - and less pronounced with regard to the potassium excretion - a gradual adaptation to the infusion of the electrolyte-free solution is observed. The excretion of the cations is more and more decreased. In particular the excretion of sodium and of potassium is very high in the initial period, i.e. in the course of the first twelve hours of the xylitol infusions. On the other hand, the potassium excretion is very low in the final period of the infusion of xylitol (during 36 hours up to 48 hours) in comparison to the other sugars.

Adult

Mean activity coefficients for the simple electrolyte in aqueous mixtures of polyelectrolyte and simple electrolyte. V. Common counterion mixtures of alkali-metal dextransulfates with alkali metal chlorides.

Mean molal activity coefficients of simple electrolyte in aqueous solutions of Li, Na, K or Cs salts of dextransulfate (DS) with added LiCl, NaCl, KCl or CsCl are reported. The measurements were carried out by means of an electrochemical cell method using a cation exchange membrane as cation selective electrode and Ag/AgCl electrodes. For LiDS-LiCl, NaDS-NaCl and CsDS-CsCl systems the polymer concentration, mp, was varied from 0.0088 to 0.113 m and at a given mp the ratio X of the polymer to salt concentration was varied from 0.5 to 16. Due to the insolubility of KDS in high concentration of KCl, the measurements on KDS-KCl system were performed in the mp range of 0.0088--0.089 m and some of the smaller X values were omitted. The activity coefficient results are compared to Manning's limiting laws, the additivity rule, and to new limiting laws. The additivity rule can give an excellent representation of the data for all mp values when gammap is used as an adjustable parameter.

Chemical Phenomena

[Frequency relations of capacitance and conductance of the system electrolyte--membrane--electrolyte in a model framework].

An electrodiffusion model of immediate permeability of ions through the lipid membrane was considered. The model suggests the existence of finite immovable layers of the electrolyte near the membrane. A technique is given for linearization and obtaining analytical solutions of the time-dependent electrodiffusion equations for one ion species. The expression for admittence of the system was obtained. The model allowed to obtain the curves of c (omega) and g (omega) which agreed with the empiric ones.

Diffusion