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May 1986

Hyperosmolar Coma Treated With Intravenous Sterile Water: A Study of Three Cases

Author Affiliations

From the Department of Anaesthesia and Intensive Care, Royal Adelaide Hospital, South Australia.

Arch Intern Med. 1986;146(5):945-947. doi:10.1001/archinte.1986.00360170175024

• Three patients with hyperosmolar coma were treated with intravenous isotonic saline, dextrose, and hypotonic saline solutions. The development of pulmonary edema and increasing hypernatremia precluded the further use of sodium solutions, and the presence of severe hyperglycemia made the further use of dextrose solutions undesirable. To provide further solute-free fluid, intravenous sterile water was administered through a central venous catheter. The hyperosmolar state improved, and all patients survived without biochemical evidence of hemolysis or clinical evidence of cerebral edema.

(Arch Intern Med 1986;146:945-947)

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