Clinical Study of Water and Electrolytes Changes of Head Injured Patients.

Jun, Dong Hwee

Original Article

Journal of Korean Neurosurgical Society 1972;1(1): 87-98.

Department of Neurosurgery, Korea University College of Medicine Seoul, Korea.

ABSTRACT

This report is a study on metabolic responses of selected forty-five head injured patients which were admitted to neurosurgical department of Woo Sok Hospital C.H. from January to August 70. The study was undertaken in an attempt to establish the basis for electrolyte or water support to head injury patients. All patients were classified into five groups according to severity of head injury. Authors studied on sodium, choloride and potasium of serum and urine at 24, 48, and 72hrs. N.P.O. in each group, and also considered the factors and mechanism, inducing hyponatremia of head injury patients, by virtue of count of either dilution or concentration of inorganic acid and protein anion which were mainly depend on water content of blood. The electrolytes were measured by the EEL flame photometry and chloride was measured by the Schales method. The characteristic of metabolic responses in electrolytes of each group are as following the results obtained. The persistent metabolic responses of head injured patients were found as mild to moderated hyponatremia compare with other site injured one and which were also depended on the severity of heed injury, acuteness of its onset the presence or absence of brain parenchymal destruction and brain swelling. The inducing factors of hyponatremia would be considered as follows: 1) Water retention. 2) Renal Na loss. 3) Intracellular Na migration from blood.