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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La hipernatremia es una alteraci&#243;n electrol&#237;tica com&#250;n&#44; aunque rara vez se debe a un exceso absoluto de sodio&#46; La hipernatremia grave debida a ingesti&#243;n de sal com&#250;n&#44; bien de forma accidental o bien como forma de maltrato infantil&#44; es una entidad infrecuente pero que conlleva una alta mortalidad&#44; as&#237; como dificultades para conseguir un tratamiento terap&#233;utico &#243;ptimo&#46; A pesar de ser f&#225;cilmente reconocible mediante las pruebas de laboratorio&#44; la determinaci&#243;n de su etiolog&#237;a es con frecuencia muy dif&#237;cil de establecer&#46; Es importante tener presente que&#44; incluso una ingesta sorprendentemente peque&#241;a de sal puede provocar una hipernatremia aguda grave con desenlace fatal&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se describen 2 casos de intoxicaci&#243;n salina grave en 2 ni&#241;as de 20 y 7 meses de edad&#44; respectivamente&#44; cuya primera manifestaci&#243;n fue hipernatremia grave y convulsiones tras la ingesta accidental de sal com&#250;n&#46; En el caso 1&#44; la administraci&#243;n inadvertida de sal com&#250;n&#44; en lugar de az&#250;car&#44; a dos yogures provoc&#243; una hipernatremia aguda y estado convulsivo&#46; En el caso 2&#44; un error en la preparaci&#243;n de la soluci&#243;n de rehidrataci&#243;n oral &#40;agua saturada con sal&#41; origin&#243; un cuadro de convulsiones&#44; coagulopat&#237;a de consumo y trombosis del seno venoso longitudinal&#46; Ambos casos fallecieron con el diagn&#243;stico de muerte encef&#225;lica&#46;</p>"
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Vol. 53. Núm. 5.
Páginas 495-498 (noviembre 2000)
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Vol. 53. Núm. 5.
Páginas 495-498 (noviembre 2000)
Acceso a texto completo
Hipernatremia grave por administración accidental de sal común
Fatal hypernatremia due to exogenous salt intake
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I. Martos Sánchez*, P. Ros Pérez, E. Otheo de Tejada, J.L. Vázquez Martínez, C. Pérez-Caballero, L. Fernández Pineda
Unidad de Cuidados Intensivos Pediátrica. Hospital Ramón y Cajal. Madrid
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La hipernatremia es una alteración electrolítica común, aunque rara vez se debe a un exceso absoluto de sodio. La hipernatremia grave debida a ingestión de sal común, bien de forma accidental o bien como forma de maltrato infantil, es una entidad infrecuente pero que conlleva una alta mortalidad, así como dificultades para conseguir un tratamiento terapéutico óptimo. A pesar de ser fácilmente reconocible mediante las pruebas de laboratorio, la determinación de su etiología es con frecuencia muy difícil de establecer. Es importante tener presente que, incluso una ingesta sorprendentemente pequeña de sal puede provocar una hipernatremia aguda grave con desenlace fatal.

Se describen 2 casos de intoxicación salina grave en 2 niñas de 20 y 7 meses de edad, respectivamente, cuya primera manifestación fue hipernatremia grave y convulsiones tras la ingesta accidental de sal común. En el caso 1, la administración inadvertida de sal común, en lugar de azúcar, a dos yogures provocó una hipernatremia aguda y estado convulsivo. En el caso 2, un error en la preparación de la solución de rehidratación oral (agua saturada con sal) originó un cuadro de convulsiones, coagulopatía de consumo y trombosis del seno venoso longitudinal. Ambos casos fallecieron con el diagnóstico de muerte encefálica.

Palabras clave:
Hipernatremia aguda
Intoxicación por sal común
Niños

Hypernatremia is a common electrolyte abnormality, but it is rarely attributable to excess sodium. Hypernatremia due to exogenous salt intake, caused either by accidental ingestion or as a form of child abuse, is rare, difficult to manage and results in high mortality. Although hypernatremia is easily recognized by laboratory tests, its etiology is often difficult to determine. A surprisingly small amount of salt intake can result in a fatal outcome.

We report two cases of severe salt intoxication in two girls, aged 20 and 7months, who presented with severe hypernatremia. Both had seizures after accidental salt ingestion. In the first case, salt instead of sugar was inadvertently added to two yoghurts, leading to hypernatremia and convulsions. In the second case, a mistake in the preparation of salt-saturated water as an oral rehydration solution provoked seizures, coagulopathy and longitudinal venous sinus thrombosis. Both cases developed encephalic death. We discuss the clinical course and the difficulties in the treatment of these cases in the context of the available literature.

Key words:
Acute hypernatremia
Salt poisoning
Children
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Bibliografía
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