REABSORPTION OF ELECTROLYTES AND WATER FROM BLOOD IN THE ALIMENTARY TRA

Journal/Book: Reprinted from THE LANCET June 16 1962 pp. 1261-1262. 1962;

Abstract: DANIEL ANDERSEN M.D. Copenhagen NIELS A. LASSEN M.D. Copenhagen From surgical department A of Bispebjerg Hospital Copenhagen Denmark PATIENTS who lose much blood into the stomach or duodenum seem to suffer less from oligæmic shock than do those who lose similar amounts from external wounds (Tibbs 1956). Further patients bleeding severely from peptic ulcers often succumb to pulmonary oedema when treated by massive blood-transfusion. Death is usually ascribed to " over-transfusion " or " overloading " (Christiansen et al. 1962). These observations suggest that the " ingested " blood has a hæmodynamic effect. Material and Methods We have studied the absorption of water and electrolytes from ingested blood in three young men-two with duodenal ulcer and one a healthy medical student. They were fed a standard diet for 6 days. On the 4th day about 2000 ml. of heparinised blood of their own blood-group was administered by stomach-tobe over a period of 2 to 5 1/2 hours. There was no vomiting or other symptoms. The blood traversed the alimentary canal in 3 to 8 hours and a melæna stool of some 450 ml. was passed. Sodium and potassium were measured in the ingested blood and in the melæna and the Output in fæces and urine was measured daily. Results The ingested blond contained between 168 and 181 mEq. of sodium and between 73 and 92 mEq. of potassium (tables t and II) (without tables). Since only 3-10 mEq. sodium and 9-19 mEq. potassium were found in the melæna stool some 95% of the sodium and 80-90% of the potassium had been reabsorbed from the blond during its passage from. the stomach to the rectum. Sodium balance in the three men is shown in the accompanying figure. On the 4th day of observation when the " bleeding " occurred some 175 mEq. of sodium were absorbed but only 50-118 mEq. was excreted in the urine and a negligible amount in the stools. ... ___MH

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