Hypernatremic Diarrheal Dehydration Treated with Oral Glucose‐Electrolyte Solution Containing 90 or 75 mEq/L of Sodium

Abstract

Summary: Of 33 infants with hypernatremic dehydration (serum Na' of ≥ 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 <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.