Records of 48 patients with acute gastro-enteritis who had a serum sodium concentration of 148 mEq/l. or more have been reviewed. All except 3 were under 1 year of age and 62% were under 6 months. In the majority of patients no single cause for the hypertonicity of the body fluids could be identified, but general factors related to acute illness and continued feeding of the infants on powdered milk in addition to breast milk contributed. Excessive administration of saline was the probable cause in only 11 patients.
Twenty-two of the 48 patients had CNS manifestations; cerebral disturbances were commoner when the serum Na concentration was 158 mEq/l. or more. 14 of the 48 patients died; with one exception all deaths occurred among patients with CNS manifestations. In view of the high risk of brain damage and mortality, the importance of prevention of hypernatraemia has been emphasized.
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