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• W2046082609 abstract "T HIS paper discusses briefly the development in diarrheal disease of deficits of body water and electrolyte on the one hand and of energy stores on the other, with the purpose of defining features of difference which have relevance to parenteral fluid therapy. Since water and the electrolytes are not destroyed within the body, they will serTe the body as long as the body can hold on to them. This is not the case for the oxidizable food substances which sustain the energy metabolism. It is their destiny to be destroyed; they serve the body only once. Reductions of uptake of water and electrolytes from the gastrointestinal tract will result from increased outgo in the stools and also from lowering of the infant's ability to accept food. The usual intake of water and electrolytes by an infant provides a very large surplus over ob]igatory outgo in the urine. So we can have large reductions of uptake from the gastro-intestinal tract which will be covered by corresponding limitation of removal of water and eleetro]ytes by the kidney. When, however, the limit of renal conservation is overpassed, deficits will develop with dangerous rapidity. The infant's food provides only the small surplus of oxidizable substances, above the requirement for energy expenditure, which is needed for growth. Even a small reduetior~ of uptake of these substances will, therefore, cause progressive depletion of the energy stores of the body. In other words, in contrast with water and electrolytes, there is no adjustment which will offset reduction of calory uptake. These are quite simple and evident physiologic propositions. The purpose of the following data is to give them ~uantitative illustration. The data in Chart I are borrowed from a recent unpublished study of water balance in infants by Pratt and Bienvenu (personal communication). The first diagram presents the values found for the components of the water exchange of a 3 kg. infant receiving a food intake composed of a usual dilution of evaporated milk. The intake of water is shown on the left side of the diagram together with the water produced within the body by oxidation of the food substances. On the outgo side we have a relatively small loss of water in the stools and the water which leaves the body by way of the lungs and skin, the so-called insensible water loss, which has an approximately stationary value. Regulation of the remainder of water outgo so as to provide the small positive balance required for growth, shown at the top of the diagram, is performed by the kidney. This water is much more than the kidney needs for excretion of the daily quantity of substances claiming removal in the urine. The measurements recorded in the next diagram of the chart are from a period during which the infant was given" @default.
• W2046082609 created "2016-06-24" @default.
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• W2046082609 date "1947-05-01" @default.
• W2046082609 modified "2023-09-25" @default.
• W2046082609 title "Deficits in diarrhea" @default.
• W2046082609 doi "https://doi.org/10.1016/s0022-3476(47)80045-9" @default.
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