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To the Editor:—
The statement that the total circulating sodium is usually normal in uncomplicated sodium redistribution is based on studies using the techniques described. As expected from theoretical considerations, serial studies show some decrease in base line levels of total plasma sodium when there is a shift of sodium into tissue depots such as bone. However, except in patients with profound disturbances in acid-base and potassium balance (where other mechanisms are invoked), in our experience, cation shifts of less than 10% do not greatly alter the total circulating sodium, and resulting values fall within the range of our reported normal levels (370 to 470 mEq. in a 70-kg. man). Justification for estimating the total circulating sodium as described is that this type of study is available in most hospitals; it is easily and quickly obtained and can be repeated serially; resulting data reduce errors made when treatment is directed
Leevy CM. CIRCULATING SODIUM ESTIMATION-Reply. JAMA. 1956;161(3):270. doi:10.1001/jama.1956.02970030088026
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