MANAGEMENT OF SALT POISONING IN AN EXTREMELY LOW-BIRTH-WEIGHT INFANT

We present the first reported case of severe salt poisoning in an extr emely low birth weight neonate. The salt poisoning was managed with th e careful use of intravenous fluids, insulin to manage the severe hype rglycemia, and furosemide to induce a saline diuresis. The hypertonici ty was normalized slowly over 3 days by following the corrected serum sodium (Na) (serum Na + 2.7 mEq for every 100 mg/dl of glucose over 10 0). No neurological damage was seen in our patient during the developm ent of the hypertonicity or its correction. This suggests that the pre mature brain can develop osmo-protective molecules if hypertonicity de velops slowly over 2-3 days. Slow correction is therefore recommended to avoid the development of water intoxication during correction. Desp ite the development of mild reversible renal failure, a large saline d iuresis was induced with furosemide, thereby avoiding the need for dia lysis in our patient. The only complication was the development of nec rotizing enterocolitis, which has not been previously reported in asso ciation with salt poisoning.