Hypernatraemia: still seen as a problem in paediatric practice.
AIMS: To illustrate that hypernatraemia is still seen as a problem in paediatric practice and to discuss its management. METHODS: A collection of four patients with hypernatraemia from different causes are reported. Recommended treatment include initial plasma expanders, where necessary, followed by gradual rehydration to prevent cerebral oedema using fluid containing 75-80 mmol/L of sodium until adequate urine output is observed, followed by a maintenance rate of solution containing 35-40 mmol/L of sodium over 48 h. RESULTS: All four patients recovered completely and without complications. CONCLUSIONS: Hypernatraemia is still seen in practice as an important problem. Recommended treatment is gradual rehydration with appropriate concentrations of electrolyte and glucose mixture.