Recognition and Management of Pediatric Salt Toxicity. Issue 11 (November 2018)

• Record Type: Journal Article
• Authors: Blohm, Eike; Goldberg, Amy; Salerno, Ann; Jenny, Carole; Boyer, Edward; Babu, Kavita
• Is Part Of: Pediatric emergency care. Volume 34:Issue 11(2018)
• Publication Date: 2018-11
• Subjects: salt poisoning -- salt toxicity -- sodium toxicity -- hypernatremia; Pediatric emergencies -- Periodicals; 618.92002505
• DOI: 10.1097/PEC.0000000000001340
• Languages: English
• ISSNs: 0749-5161

Abstract

Abstract : Objectives: Immediate recognition of salt toxicity and aggressive resuscitative measures are critical in the treatment of this lethal poisoning. Despite heroic measures, pediatric deaths due to salt toxicity still occur from irreversible neurological damage. The objective of this article is to review the relevant literature and offer a therapeutic algorithm for the management of pediatric patients presenting with salt toxicity. Methods: A literature search for cases of salt toxicity was conducted. Articles in English that were available electronically through PubMed and Google Scholar were reviewed. Results: Nineteen cases and case series of salt toxicity were located using our search strategy. Salt poisoning has a distinct pathophysiology compared with hypernatremia, most notable for the lack of formation of idiogenic osmoles. Conclusions: The approach to treatment differs between salt toxicity and hypernatremia, focusing on rapid correction of serum osmolality rather than gradual normalization of serum sodium concentrations. Consultation of nephrology and child protection services are strongly recommended in the comprehensive treatment approach.