We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Spirolactone Effect on Postoperative Electrolytes and Adrenal Activity

Robert H. Seller, MD; Osvaldo Ramirez-Muxo, MD; Charles Swartz, MD; Nicholas Pitha, MD; Albert N. Brest, MD
JAMA. 1963;186(11):994-998. doi:10.1001/jama.1963.63710110001010.
Text Size: A A A
Published online


NOT LONG AFTER intravenous sodium chloride solutions became available for human use, they were administered to surgical patients. It soon became apparent that salt was retained during the postoperative period to such a degree that some patients became edematous and a few developed overt congestive heart failure after sodium chloride administration. In 1945, Coller and associates quantitated postoperative salt retention by the use of a sodium chloride solution infusion. They found that patients retained approximately 50% of an intravenous sodium chloride solution load during the first 30 hours after an abdominoperineal resection.1 Although stress-induced adrenal cortical hyperactivity was postulated as a cause of postoperative salt retention, the minimal mineralo-corticoid activity of cortisone or cortisol did not appear to account for the marked salt retention. In 1952 aldosterone, a corticosteroid which possesses one thousand times the salt-retaining potency of cortisone, was isolated.2 Subsequently the role of aldosterone as


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.