[Changes in total body potassium and ion distribution compartments in general surgery and intensive care patients]

Measurements of total body potassium in a whole body counter revealed significant total body potassium depletion in patients suffering from high output enteric fistulas, short bowel syndrome and Crohn's disease. The clinical importance of this finding is derived from the fact that the degree of potassium depletion was found to be related to mortality, and that the introduction of an infusional regimen for preparation for surgery in Crohn's disease which effected intracellular potassium refilling resulted in a decreased surgical mortality and complication rate. In conclusion specific nutritional support as an essential measure in preparing such patients for elective surgery is particularly recommended. Significant cellular potassium depletion was also found in critically ill patients dying from sepsis. In contrast to the aforementioned diseases with malnutrition, where an increased fecal loss of potassium is the most likely cause of potassium deficiency, a different mechanism for cellular potassium loss is suggested in this condition from additional indicator dilution studies. Rather here the finding of increased distribution volumes for ions physiologically predominantly restricted to the extracellular space (82Br and 24Na) indicates a change of cell membran permeability suggestive of so called sick cell syndrome.