Controlled fall in natremia and risk of seizures in hypertonic dehydration

Abstract

The aim of the study was to derive some practical measurements which might help in defining a “safe” infusion rate in order to avoid seizures during treatment of hypernatremic dehydration. Forty seven infants with hypernatremic dehydration were rehydrated on a 160 ml/kg/24 h basis: 9 developed seizures during treatment (group I), 22 matched for age did not convulse (group II). Nine subsequent cases were prescribed a 120 ml/kg/24 h regimen: none convulsed (group III). The three groups were comparable in many respects, including initial plasma Na and pH. Fluids were comparable regarding (Na), their rates of administration were respectively 216, 181 and 123 ml/kg/24 h. The rate of infusion affected slopes of decreases in natremia. It was suggested that the decrease in plasma Na should not exceed 0,5 mEq/l/h.