Abstract
Elevated plasma arginine vasopressin concentrations [AVP] and cerebral edema occur in BM. Therefore fluid restriction has been recommended in early management. However dehydration may also increase [AVP] and fluid restriction may decrease cerebral perfusion. A randomized, prospective study is in progress to establish the relationship between initial hydrastatus and [AVP], and to determine the effect of rehydration or fluid restriction on subsequent [AVP]. Six children with BM have been studied to date (table). Hydration was estimated clinically and determined by bromide space. [AVP] was measured at presentation, 24 hours later, and at the end of antibiotic therapy. No patient developed hyponatremia, SIADH, or fluid overload.
Results to date suggest that children with BM are often dehydrated at the time of presentation and that replacement fluid therapy results in the normalization of [AVP].
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Sugarman, L., Woodin, K., Eskenazi, A. et al. FLUID MANAGEMENT IN BACTERIAL MENINGITIS (BM). Pediatr Res 21 (Suppl 4), 207 (1987). https://doi.org/10.1203/00006450-198704010-00246
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DOI: https://doi.org/10.1203/00006450-198704010-00246