title: Hypernatremic diarrheal dehydration treated with oral glucose-electrolyte solution containing 90 or 75 mEq/L of sodium.
abstract: Of 33 infants with hypernatremic dehydration (serum Na+ of greater than or equal to 150 mEq/L) 7 were excluded, 6 because severe alteration of the level of consciousness or shock precluded oral rehydration and 1 because he was given glucose-electrolyte solution plus water. We studied the remaining 27 infants. Twenty (group A) were treated with the World Health Organization-recommended oral rehydration solution (90 mEq/L Na+) and seven (group B) were treated with Pedialyte-RS (Abbott Laboratories Ltd.; 75 mEq/L Na+). The rehydrating solutions were administered in a volume equivalent to twice the clinically estimated fluid deficit. Initial serum sodium was 156.7 +/- 0.9 mEq/L for group A and 155.8 +/- 1.8 mEq/L for group B (mean +/- SEM). The mean time to achieve rehydration was 14.3 and 16.6 h for groups A and B, respectively. Twenty-four hours after commencing oral rehydration, serum Na+ had decreased to 144.8 +/- 1.8 mEq/L for group A and 144.5 +/- 0.9 mEq/L for group B. In two patients in group A, the serum Na+, which, had not decreased to less than 150 mEq/L at 24 h, did so at 48 h. Only in one case (group A) did the serum Na+ increase. This patient had high stool output and failed to become rehydrated after 24 h of unsuccessful oral rehydration. None of the patients had seizures or persistent CNS dysfunction. We conclude that the slow administration of oral rehydration solutions containing either 90 or 75 mEq/L Na+ is a safe and effective treatment of hypernatremic dehydration.
authors.affiliation: Department of Medicine, Hospital Nacional de Niños, San José, Costa Rica.
authors.forename: C
authors.initials: C
authors.lastname: Guzmán
authors.forename: D
authors.initials: D
authors.lastname: Pizarro
authors.forename: B
authors.initials: B
authors.lastname: Castillo
authors.forename: G
authors.initials: G
authors.lastname: Posada
mesh_terms: D003681:Dehydration / Q000209:etiology / Q000628:therapy*; D003968:Diarrhea, Infantile / Q000150:complications*; D004573:Electrolytes / Q000008:administration & dosage; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D006955:Hypernatremia / Q000097:blood / Q000150:complications*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009994:Osmolar Concentration; D011188:Potassium / Q000097:blood; D012964:Sodium / Q000008:administration & dosage
chemical_list: D004573:Electrolytes; D012964:Sodium; D005947:Glucose; D011188:Potassium