Electrolyte therapy after abdominal surgery. A balance study of sodium, potassium, calcium, magnesium and phosphate in total parenteral nutrition
Jacobson, S.
Acta Chirurgica Scandinavica 143(5): 285-296
1977
ISSN/ISBN: 0001-5482 PMID: 413299 Document Number: 121154
Na, K, Ca, Mg and phosphate were estimated in 24-h urine of 16 patients on total parenteral nutrition (TPN) for 5 days after gastrointestinal surgery. The TPN solutions included fat emulsion (Intralipid (R) , 20%), carbohydrates, amino acids, electrolytes, vitamins and trace elements. Of the 16 patients 9 showed substantial nasogastric tube loss on the first 2 days after operation. The electrolyte balances were expressed as the differences between the intravenous supply and the 24-h urinary excretion. During TPN, Hb and serum Na and Ca decreased slightly from the values before operation, whereas serum K and phosphate increased. In the nasogastric tube group the mean balances of Ca, K and phosphate after operation were slightly negative during the first 2 days. In the patients without nasogastric tube the mean balances of Na, K, Mg and phosphate were positive throughout, with the exception of Na and phosphate on the first day, whereas the balance of Ca was generally negative. In the nasogastric tube group there was a close correlation between the supply and the balance of Na and K on day 2, but for the remaining days the correlation was weak, as it was also for the other elements. Retention of water and Na after operation did not attain the magnitudes reported in earlier studies. Tentative recommendations are presented for electrolyte treatment after operation.