Hypernatraemic dehydration in infants in Kuwait with special reference to therapy of associated metabolic acidosis.

Over a period of 16 months 510 children with diarrhoea were admitted to the Al-Adan Hospital, Kuwait, of whom 26 (5.1%) developed hypernatraemic dehydration. Prominent clinical features included vomiting (92.3%), fever (84.6%) and convulsions (19.2%). The majority were below six months of age with a mean age of 3.1 months. The sex distribution was equal. Twenty infants (77%) had severe metabolic acidosis and were treated with a combination of sodium bicarbonate and 5% glucose in water until the acidosis was corrected after which a solution of sodium chloride replaced the use of sodium bicarbonate. The sodium concentration of the intravenous fluid varied from 15 to 30 mmol/l and was given at a rate of 100 to 120 ml/kg/day. One infant died. The 25 survivors, (96.15%), which included three who developed convulsions during treatment, recovered without any neurologic sequelae.