Prolonged controversy has existed concerning the proper role of isotonic salt solutions in the postoperative and post-traumatic periods. It is of interest that Coller et al1 and Shires and Jackson2 in published reports 18 years apart presented diametrically opposed titles and conclusions. In recent years the retention of sodium and water by the postoperative patient has been well documented and has led to a generally held concept of a postoperative and post-traumatic renal intolerance to water and salt. Consequently, it has become customary, in many clinics, to restrict avidly isotonic salt solutions postoperatively. However, from the reports of Randall and Papper,3 and more recently Shires et al,4 it would appear that the post-operative retention of sodium is related to a diminution in the effective or circulating extracellular fluid volume rather than to an enhanced output of adrenal cortical steroids (17-hydroxycorticosteroids and aldosterone). Strauss5 and Smith
WOLFMAN EF, NEILL SA, HEAPS DK, ZUIDEMA GD. Donor Blood and Isotonic Salt SolutionEffect on Survival After Hemorrhagic Shock and Operation. Arch Surg. 1963;86(5):869–873. doi:10.1001/archsurg.1963.01310110179023
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