| Fluid and Electrolyte Therapy in Epidemic Encephalitis
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Suhung Hann |
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Department of Pediatrics, College of Medicine Seoul National University |
| 流行性腦炎患者 低 Na血症의 療法에 對하여 |
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韓 秀 雄 |
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서울大學校 醫科大學 小兒科學敎室 |
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| Abstract |
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Of patients with epidemic encephalitis in 1962, 55 patients, two to seventeen years of age, were observed
on the change of concentration of serum electrolytes, and the effect of fluid and electrolyte therapy on the
correction of hyponatremia and the improvement of the symptoms. Hyponatremia below 132 mEq/L was found in 23 cases on admission and in other 21 during the course, totaling 44 cases (80% of all patients) during their
acute stage in which time the impairment of consciousness was utmost. These figures appear to cast a
certain possible relationship between the concentration, of serum sodium and the severity of clinical symptoms
Hyponatremia was treated in five groups; Of patients with epidemic encephalitis in 1962, 55 patients, two to seventeen years of age, were observed on the change of concentration of serum electrolytes, and the effect of fluid and electrolyte therapy on the correction of hyponatremia and the improvement of the symptoms.
1) 60%correction group (9cases) 2)30%(orrection group (12 cases) 3)30%corerction with prednisolone group(lleases) 4)30%( orrection with prednisolone and gammaglobuln group (5 cases) 5) control group (11 cases) Sodium deficit was calculated as follows: For 60% correction group, the total sodium amount needed was given over the first 24 hours while for 30% correction group the half of it over the initial 24 hours.
The fluid given was exclusively 10% dextrose in water and was infused in rate of 80-90 ml/100 calories metabolized, 12% of total fluid being added for 1° C. rise in the body temperature above 37C. There wss no apparent difference in the speed of correction of the hyponatremia following administration of hypertonic saline solution among the correction groups but they showed as a whole more rapid corre ction than control group. As far as symptomatic improvement concerned, which was based mainly on the improvement of the state of consciousness, the 60 % correction group appeared to be superior to the 30 % correction group. Prednisolone or gammaglobulin or both appeared to have little benefit for the correction of hyponatremia but 30% correction combined with prednisolone, 20mg/day for 2-6 days, appeared to be more effective than 30% correction only in the improvement of the state of consciousness. |
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