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Abstract
Hypernatremia is a common electrolyte disturbance, results when the water content of body fluids is deficient compared with sodium content, hypernatremia can be the result of sodium excess but is usually associated with dehydration, secondary to excess losses of water or hypotonic fluids.
The clinical manifestations vary and depend primarily on the degree of deypdration and the rate at which the hyperosmolar state has been reached than hyponatremic or isonatremic dehydration, but is associated with the highest morbidity and mortality rate, primarily related to CNS Dysfunction. Even the CNS damage can result, either as a consequence of the hypernatremia itself or of rapid lowering of the serum sodium concentration.
This study included 108 patients ( aged from 4 months to 2 years) with hypernatremic dehydration. The aim of the work was to identify predictive factors of high mortality and morbidity in these patents and comparison between IMCI and traditional methods of management of hypernatremic dehydration. Medical records were reviewed to obtain the following data: a) history of illness as regards frequency of diarrhea, type of feeding, and misuse of packets of ORS taken, b) clinical examination including state of dehydration, signs of brain edema, nutritional status and convulsions, e) laboratory data including repeated levels of serum sodium, potassium, cratinine BUN, calcium and arterial blood gases, d) strategy of management by classic or IMCI.