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April 1977

Heat Stroke in Infancy-Reply

Author Affiliations

Department of Pediatrics Vanderbilt School of Medicine Nashville, TN 37203

Am J Dis Child. 1977;131(4):472. doi:10.1001/archpedi.1977.02120170098023

In Reply.—The primary purpose of our article on heat stroke was to emphasize two points: (1) that it is potentially dangerous to leave children in parked automobiles during hot summer months, and (2) that dehydration is important in the pathogenesis of heat stroke and that reexpansion of intravascular volume should be a part of initial treatment.1 In the patient presented, fluid and electrolyte replacement was not initiated at the first hospital and was delayed for another two hours in route to Vanderbilt Hospital. In spite of continuous sponging and antipyretics, the child's temperature remained elevated and other organs (particularly the central nervous system) showed signs of impairment. As stated in the case report, most blood chemistry studies, other than those given, were normal at the time of admission (Na, 144 mEq/liter; K, 4.9 mEq/liter; urea, 23 mg/100 ml; glucose, 98 mg/100 ml). No bicarbonate was given although the

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