Severe sodium depletion occurred in association with treatment of burn injury by repeated submersion in water. There was associated azotemia and loss of potassium and extracellular volume. The abnormalities were promptly reversed with replacement therapy. A primary loss of electrolyte through the burned surface into the whirlpoolbath water is postulated.
Gotshall RA. Sodium Depletion Related to Hydrotherapy for Burn Injury. JAMA. 1968;203(11):984-986. doi:10.1001/jama.1968.03140110076021