Prolonged postoperative ileus (PPOI) occurs in around 15% of patients after major abdominal surgery, posing a significant clinical and economic burden.

A new article published in Physiological Reports evaluated peri‐operative electrolyte concentration trends and their association with ileus, and predicted the impact on bioelectrical slow waves in interstitial cells of Cajal (ICC) and smooth muscle cells (SMC).

In this joint clinical‐theoretical prospective study, data were collected from 327 patients undergoing elective colorectal surgery.

The findings showed that – on the postoperative day (POD) 1 calcium and POD 3 chloride, sodium were lower in the PPOI group and POD3 potassium was higher in the PPOI group. Deficits beyond the reference range in PPOI patients were most notable for sodium. Models demonstrated an 8.6% reduction in slow‐wave frequency after the measured reduction in extracellular NaCl on POD5 was associated with changes in cellular slow‐wave morphology and amplitude.

The results suggested that low serum sodium and chloride concentrations are associated with PPOI. Electrolyte abnormalities are unlikely to be a primary mechanism of ileus. However, electrolyte abnormalities may adversely impact motility recovery. Hence, resolution and correction of electrolyte abnormalities in ileus may be clinically relevant.

Source: Physiological Reports.2021 Feb; 9(3): e14735. doi: 10.14814/phy2.14735