Maclean D, Champion M, Trash D B
Postgrad Med J. 1976 Aug;52(610):532-5. doi: 10.1136/pgmj.52.610.532.
Acute water intoxication with deepening coma and uncontrolled epileptiform seizures in a 25-year-old previously fit male schizophrenic was treated with hypertonic (2 N) saline and a 20% mannitol solution. This improved his neurological state but precipitated severe pulmonary oedema. Intravenous frusemide increased his urinary output sufficiently to clear the pulmonary oedema. In acute water intoxication the use of hypertonic solutions may thus precipitate left heart failure by expanding the intra-pulmonary blood volume beyond the capacity of even a healthy left ventricle to compensate. Simple water restriction will produce a slower but perhaps safer improvement.
一名25岁、此前身体健康的男性精神分裂症患者发生急性水中毒，出现昏迷加深和无法控制的癫痫样发作，接受了高渗（2N）盐水和20%甘露醇溶液治疗。这改善了他的神经状态，但引发了严重肺水肿。静脉注射速尿使他的尿量充分增加，从而清除了肺水肿。因此，在急性水中毒时，使用高渗溶液可能会使肺内血容量增加到即使是健康的左心室也无法代偿的程度，从而引发左心衰竭。单纯限制水分摄入会使病情改善较慢，但可能更安全。
