Fluid management of hypernatraemic dehydration to prevent cerebral oedema: A retrospective case control study of 97 children in China

Abstract

The key risk factors for the development of cerebral oedema during recovery from hypernatraemic dehydration were too rapid a rate of rehydration, an initial fluid bolus to rapidly expand plasma volume and the severity of the hypernatraemia. Thus, we conclude that a uniformly slow rate of rehydration is the best way of preventing cerebral oedema.

Pathophysiology, diagnosis and management of nephrogenic diabetes insipidus

“…The main risk of a rapid decrease in plasma sodium is cerebral oedema and potentially death. [94][95][96][97] Consequently, careful fluid balance and frequent monitoring of clinical state and biochemistries is key to safe treatment and requires a clinical environment with sufficient experience in the treatment of complicated electrolyte disorders. Fluids should be taken orally as soon as feasible, to enable the thirst physiology to properly regulate fluid intake.…”

The Reduction Rate of Serum Sodium and Mortality in Patients Undergoing Continuous Venovenous Hemofiltration for Acute Severe Hypernatremia

“…Neurological diseases can result in cerebral edema and elevated intracranial pressure; hypernatremia appears to reduce the intracranial pressure and alleviate cerebral edema in patients with neurological diseases (30). The excessive correction of hypernatremia can aggravate cerebral edema or cause permanent neurological damage or death (14,31,32). Therefore, the recommended RRSeNa in acute hypernatremia (2 mEq/L/h) may not be suitable for critically ill patients, especially those with neurological diseases.…”

Normal saline is a safe initial rehydration fluid in children with diarrhea-related hypernatremia

“…A recently published large retrospective study of 97 children with hypernatremic dehydration found that using an initial fluid bolus was among the key factors in developing cerebral edema [5].…”