The management of extreme hypernatraemia secondary to salt poisoning in an infant

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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

O Paut1, N André, P Fabre

  • 1Département d'anesthésie-réanimation pédiatrique, Salvator hospital, Marseille, France.

Paediatric Anaesthesia
|April 6, 1999
PubMed

Insights

This case report details a five-week-old infant with extreme hypernatremia due to accidental salt poisoning from a homemade formula. Prompt fluid therapy led to a full recovery without lasting effects.

Area of Science:

  • Pediatrics
  • Toxicology
  • Nephrology

Background:

  • Accidental salt poisoning is a rare but serious condition in infants.
  • Extreme hypernatremia can result from improper formula preparation.

Observation:

  • A five-week-old infant presented with seizures and severe hypernatremia (serum sodium 211 mmol/L).
  • Clinical features included moderate dehydration, renal insufficiency, and preserved urine output with high urinary sodium.
  • The infant developed seizures and pulmonary edema during intensive care unit (ICU) stay.

Findings:

  • Hypotonic dextrose fluid therapy successfully corrected the hypernatremia and dehydration over 48 hours.
  • Mechanical ventilation was required for five days due to pulmonary edema.
  • Complete recovery was achieved with no sequelae after a ten-month follow-up.

Implications:

  • Early recognition and management of salt poisoning are crucial for favorable outcomes.
  • Fluid therapy alone is effective in treating hypernatremia due to salt poisoning when renal function is preserved.
  • This case highlights the importance of proper infant formula preparation and awareness of potential toxic ingestions.

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