Oral sodium loading in normal individuals.

At the commencement of the Peru Burn Project (1) in 1951, great apprehension was aroused in many by the use of large quantities of isotonic saline solutions 6 in the treatment of burned patients, for it was believed that such therapy in individuals retaining sodium due to the stress reaction would overload the circulation and lead to death in pulmonary edema. The reason for this fear was based upon the knowledge that man, in contrast to the dog, retained a great part of the sodium administered as isotonic sodium chloride over a considerable period of time (2, 3). Yet, during the course of the study of 110 burned children and 83 burned adults to whom had been given orally a quantity of an isotonic saline solution equivalent to 10 per cent of body weight during the first 24 hours after thermal injury and half that amount during the second 24-hour period, no untoward effects due to sodium, such as vomiting, generalized edema or massive pulmonary edema, were encountered (1), in spite of the fact that these patients demonstrated marked water and sodium retention (largely the result of accumulations in the burned area as edema fluid). The experimental conditions of sodium loading in previous studies of normal subjects did not duplicate those utilized in the treatment of burned patients Hence, a quantity of isotonic saline solution similar to that given to burned patients was administered to normal persons over the same time period in order to clarify the effects of such sodium loading upon the kidney and circulation.