Abstract

CANTO-MANGANA, J; RUBIO-CALVO, D; AZNAR-GARCIA, M  and  AGUILAR-MARTINEZ, MM. St Marks solution as an alternative to the management of hyponatremia in ileal fistula. Rev. OFIL·ILAPHAR [online]. 2022, vol.32, n.3, pp.304-306.  Epub Sep 25, 2023. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x20220003000017.

Fistulas, especially those with high output, frequently require hydration and aggressive electrolyte replacement, highlighting sodium losses as the main hydroelectrolytic complication.

53-year-old man who underwent surgery in July 2017 and who was admitted in November 2018 for intestinal transit reconstruction. After several surgical interventions, a high-output piostercoraceous fistula appeared at the ileus level. Management of the fistula was conservative with individualized total parenteral nutrition, achieving optimal fluid and electrolyte balance. Subsequently, the patient lost both the central and peripheral venous access, being several days without vascular access. During this period, the patient developed severe hyponatremia that the Pharmacy service treated orally with a specific hydration solution, St Marks's solution, which is characterized by its high sodium and low potassium content to avoid hyperkalemias that can give rise in these patients. With the established treatment, it was possible to recover the levels of natraemia avoiding neurological complications until finally peripheral venous catheterization was placed. In our patient, this solution turned out to be effective, managing to drastically raise the levels of natraemia close to normal values. Thus, the St Marks solution can be an alternative to the intravenous access when it is not available or even be complementary to it

Keywords : St Marks; hyponatremia; fistula.

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