Ninety infants with severe hypernatraemic dehydration (plasma sodium greater than 150 mmol/l) were studied. Most had had a convulsion before admission. They were allocated to two treatment groups. Both groups received intravenous plasma followed by slow intravenous rehydration and correction of acidosis. In addition, one group received intramuscular phenobarbitone, the other group received dexamethasone 0.3 mg by intramuscular injection every 6 hours for 48 hours. Fewer infants receiving dexamethasone had convulsions during treatment (18% compared with 52%), and fewer (18%) of them died than in the group who did not receive dexamethasone (40%). Dexamethasone may have a role in the management of hypernatraemic dehydration in infants.
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