WATER AND ELECTROLYTE STUDIES IN CHOLERA *

Abstract

17 of 25 patients with diarrhea during a 1958 Bangkok cholera epidemic were found to have cholera. Quantitative volumetric studies of water and electrolytes in plasma feces and urine were made during the first 24 hours after admission in these 17 positive cholera patients. In addition the effect of water and sodium loading on electrolyte exchange was also studied and whole blood and plasma analyses were repeated during convalescence. During the first 24 hours of hospitalization patients were given only intravenous electrolyte solutions at an infusion rate related to hydration and electrolyte concentrations in plasma feces and urine. At admission hyperosmolarity was evident and plasma sodium and chloride levels were elevated. When plasma feces and urine levels of sodium and chloride were associated with osmolarity it was found that fecal osmolarity and fecal sodium and chloride were lower than corresponding plasma levels whereas fecal potassium and bicarbonate levels were higher. In this clinical study the infusion of .58 mEq of HCO-3 as sodium bicarbonate elevated plasma carbon dioxide 1 mEq/liter. The article ends with a discussion of the volume and transit of fecal electrolyte concentrations and the possible ramifications of these findings in relation to experimental studies on active transport in the bowel.