THE LOW SODIUM SYNDROMES OF SURGERY

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Abstract
An acute lowering of the plasma sodium concentration is always a sign of trouble in patients who have undergone surgery. Even in instances in which the plasma sodium concentration has been lowered to levels between 130 and 135 mEq. per liter for many months by dietary restrictions or visceral disease, the situation bodes ill if trauma is then superimposed. The clinical picture that accompanies a low serum sodium level in patients undergoing surgery consists primarily of weakness, anorexia, and lethargy. The patient may be disoriented or comatose, his reflexes are sluggish and his responses slow. Urine formation is usually very slow, gastrointestinal function is poor, some edema may be present, and the patient looks "washed out." If the patient is in the postoperative period, convalescence may seem to have ceased its dynamic daily progression and appear "stalled." If acute trauma is superimposed, blood pressure is poorly maintained. This picture is

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