Original communication| Volume 31, ISSUE 5, P654-669, May 1952

Observations on water intoxication in surgical patients

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      Seventeen instances of convulsive seizures following surgical operations and characterized by dilution of the extracellular electrolytes are reported. In all but one of these the convulsions occurred between 12 and 48 hours after the operation. In most instances, strongly positive fluid balance was demonstrable by the intake and output data and the change in body weight. The mechanisms of water intoxication are discussed in the light of previously reported experimental findings and the physiologic peculiarities of the postoperative patient.
      It is concluded that most complications of this nature could be prevented by the avoidance of excessive amounts of glucose solution at the time of surgery and through the days immediately following surgery. Daily estimations of the body weight and determinations of serum electrolyte levels before actual disturbances develop should make it possible to take measures to prevent this complication before it occurs. Hypertonic saline solution has been of great value in rapidly restoring the normal salt-water relationship of the extacellular fluid once seizures have occurred.
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