Worthley L I, Thomas P D
Br Med J (Clin Res Ed). 1986 Jan 18;292(6514):168-70. doi: 10.1136/bmj.292.6514.168.
Five patients with severe hyponatraemia and epileptiform seizures were given 50 ml of 29.2% saline (250 mmol) through a central venous catheter over 10 minutes to control seizures rapidly, reduce cerebral oedema, and diminish the incidence of permanent neuronal damage. The saline controlled seizures in all patients, increasing the mean serum sodium concentration by 7.4 (SD 1.14) mmol(mEq)/l and decreasing the mean serum potassium concentration by 0.62 (0.5) mmol(mEq)/l. Further saline and frusemide were then administered over 10 (2) hours, raising the serum sodium concentration by 2.14 (0.49) mmol/l/h until it reached 133 (2.35) mmol/l. A total of 790 (139) mmol saline was infused and a negative fluid balance of 3.34 (0.75) litres achieved. Four patients survived without neurological abnormality. One patient, who was not treated immediately and suffered a prolonged episode of status epilepticus, was left with a permanent neurological defect.
五名患有严重低钠血症和癫痫样发作的患者通过中心静脉导管在10分钟内输注了50毫升29.2%的盐水（250毫摩尔），以迅速控制癫痫发作、减轻脑水肿并降低永久性神经元损伤的发生率。盐水使所有患者的癫痫发作得到控制，平均血清钠浓度升高7.4（标准差1.14）毫摩尔/升（毫当量/升），平均血清钾浓度降低0.62（0.5）毫摩尔/升（毫当量/升）。随后在10（2）小时内进一步给予盐水和速尿，使血清钠浓度以2.14（0.49）毫摩尔/升/小时的速度升高，直至达到133（2.35）毫摩尔/升。总共输注了790（139）毫摩尔盐水，实现了3.34（0.75）升的负液体平衡。四名患者存活且无神经功能异常。一名未立即接受治疗且癫痫持续状态持续时间较长的患者留下了永久性神经功能缺陷。
