Possibility of iatrogenic factors responsible for hypernatremia in dehydrated infants.

Current trends in the therapy of acute diarrheal disease in infants and children may be responsible for the reported increase in the incidence of hypernatremia. In a series of 47 cases, 10 patients were found to have a serum sodium concentration of 150 mEq. per liter or above. These patients, mildly ill initially, became hypernatremic after receiving medical care as follows: the prescription of abnormally large quantities of liquids with high salt content for oral ingestion (seven cases), the administration of isotonic sodium chloride solution by hypodermoclysis (two cases), or the intravenous administration of electrolyte solutions at too rapid a rate (two cases). The resulting hypernatremia produced coma in nine cases, convulsions in six cases, death in two cases, and persistent convulsive disorders in three cases.