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Dehydration and hypernatraemia should be corrected slowly; over a period of 48 hours. The more hypernatraemic the patient, the more gradual is the correction.
Although oral rehydration is preferable, intravenous fluids are often necessary.
Hypotonic fluids should be avoided.
Some clinicians give dextrose 5% i.v. slowly with administration guided by plasma sodium and urine output. Other clinicians recommend the use of 0.9% saline - this is because this this results in less marked fluid shifts and is hypotonic in a hypernatraemic patients (relatively hypotonic).
Excessively rapid rehydration may result in cerebral oedema.
The management of dehydration and hypernatraemia caused by diabetes insipidus is described elsewhere.
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