Albert J. Boyle

Fluid and Electrolyte Balance during Recovery from High-Output Heart Failure Due to Beri-beri

The pathogenesis of congestive heart failure is still obscure. Previous studies showed a decrease in cellular osmolarity during recovery from low output failure. A similar trend was found during recovery from high output failure due to beriberi, suggesting an analogous cellular disturbance. It is postulated that increased cellular osmolarity is an important factor in the retention of water and sodium associated with the development of congestive failure.

Electrolyte Studies in Heart Failure

Muscle analyses for water, potassium, and chloride were made in 10 cardiac patients during and after congestive heart failure. The potassium content per unit of wet tissue during failure was 30.1 per cent less than that during compensation. The concentration of potassium in the intracellular water increased from 116 mEq. per liter to 151 mEq. per liter with compensation. Calculated extracellular water decreased, but no change in intracellular water per unit of tissue solids was found.

Electrolyte Studies in Heart Failure II. Extracellular Factors in the Pathogenesis of Congestive Edema

Indirect metabolic studies and direct muscle biopsy studies have indicated diminution of intracellular electrolyte concentration during congestive heart failure explainable by extrusion of these electrolytes due to increase in osmolarity within the cells. Acute and chronic physical and circulatory stress in cardiac patients produced an elevation of plasma sodium concentration indicative of a concomittant increase in osmolarity of the extracellular fluid.

Fluid and electrolyte balance during recovery from high output heart failure due to beriberi

The pathogenesis of congestive heart failure is still obscure. Previous studies showed a decrease in cellular osmolarity during recovery from low output failure. A similar trend was found during recovery from high output failure due to beriberi, suggesting an analogous cellular disturbance. It is postulated that increased cellular osmolarity is an important factor in the retention of water and sodium associated with the development of congestive failure.