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August 1983

Oral Rehydration in Hypernatremic and Hyponatremic Diarrheal Dehydration: Treatment With Oral Glucose/Electrolyte Solution

Author Affiliations

From the Dr Carlos Saenz Herrera National Children's Hospital (Drs Pizarro, Posada, and Mohs and Ms Villavicencio) and the University of Costa Rica School of Medicine (Drs Pizarro, Posada, and Mohs), San José, and the Center for Vaccine Development, University of Maryland School of Medicine, Baltimore (Dr Levine).

Am J Dis Child. 1983;137(8):730-734. doi:10.1001/archpedi.1983.02140340014003

• Ninety-four well-nourished, bottle-fed infants with hypernatremic (N = 61) or hyponatremic (N=33) diarrheal dehydration were treated with oral rehydration. In 61 hypernatremic and 25 hyponatremic infants, two thirds of the fluid volume were given as glucose/electrolyte solution containing 90 mmole of sodium per liter and one third as plain water; the other eight hyponatremic infants were given glucose/electrolyte solution alone. Fluid deficits were successfully and rapidly replaced with oral therapy alone in all 61 hypernatremic infants (mean±SEM, 8.5±0.6 hours) and in 31 of those with hyponatremia (mean ± SEM, 10 ±1.2 hours). Two hypernatremic infants required some intravenous (IV) fluids. The mean serum sodium levels fell in the hypernatremic infants to normal and rose in those with hyponatremia. Only five (8%) of the 61 hypernatremic infants manifested convulsions during oral rehydration; this compared favorably with the 14% rate of convulsions encountered previously when we used IV rehydration.

(Am J Dis Child 1983;137:730-734)