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December 1955

metabolic Derangements Imperiling the Perforated Ulcer PatientII. Derangements and Shifts of Intracellular Electrolytes; The Need for Potassium

Author Affiliations

From the Department of Surgery, Harvard Medical School, and the Surgical Services, Massachusetts General Hospital.

AMA Arch Surg. 1955;71(6):839-852. doi:10.1001/archsurg.1955.01270180045006

INTRODUCTION  The dehydration accompanying peptic ulcer perforation disrupts the normal distribution of electrolytes within the body. If ulcer patients are to be given the best opportunity to overcome their peritonitis, parenteral therapy must be based on an understanding of the ionic shifts involved. It is conceivable that hydration with fluids lacking the electrolytes of which the cells have been deprived may embarrass further an already burdened cellular metabolism.To obtain insight into the fluid and electrolyte shifts between the cells and their environment, we have followed the changes in serum concentration and balances of the two major intracellular electrolytes, potassium and phosphorus.* It was of interest to see whether the two ions were handled by the perforated ulcer patient in the same manner, both being important to bodily function. Although both are intracellular, they differ in storage and in the number and nature of the metabolic processes into which they

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