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October 1992

Treatment of Water Intoxication With Mannitol

Author Affiliations

Department of Pediatrics MetroHealth Saint Luke's Medical Center 11311 Shaker Blvd Cleveland, OH 44104
Pediatric Critical Care St Joseph's Hospital and Medical Center 2828 N Central Ave Suite 890 Phoenix, AZ 85004

Am J Dis Child. 1992;146(10):1130-1131. doi:10.1001/archpedi.1992.02160220016005

Sir.—We read with interest the article by Keating et al,1 published in the September 1991 issue of AJDC. We certainly agree with the authors' conclusion that this entity is underreported and may constitute a major problem within the poverty-stricken inner-city population. However, we would like to suggest an alternative mode of therapy that we have used during the past 8 years to treat the cerebral edema that can result from acute water intoxication. The following is an example of our treatment regimen.

Report of a Case.—A 3-month-old previously healthy and neurologically normal male child of an unmarried, borderline mentally retarded 15-year-old girl presented to the emergency department with tonic-clonic movements of all extremities followed by lethargy. The rectal temperature was 34.9°C; heart rate, 108 beats per minute; respiratory rate, 40 breaths per minute; and blood pressure, 89/40 mm Hg. The infant did not have respiratory difficulty, was

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