Microencapsulated NaCl for oral salt-replacement therapy in infants.

Hyponatremia in patients with brain tumors, cerebral injury, or after brain surgery is frequently caused by inappropriate secretion of antidiuretic hormone, requiring therapy by fluid restriction (1,2). Cerebral salt wasting, another cause of hyponatremia, requires, however, substitution of fluid and sodium (3). Prolonged application of NaCl via intravenous lines is of limited practicality, and oral replacement of concentrated NaCl solution may cause nausea and emesis. The unpleasant salty taste may require a nasogastric tube for application, especially in pediatric patients. Repetitive placements maneuvers are stressful for patients, parents, and the medical staff. In this correspondence, we present an alternative for oral NaCl replacement, sustained-release, microencapsulated NaCl. A 10-month-old girl presented with an incompletely resectable brain tumor (pilocytic astrocytoma) from the third ventricle to the pituitary gland, with infiltration of the optic chiasma. The postoperative phase was complicated by polyuria and excessive natriuresis. Serum sodium, chloride, and osmolality were low, whereas potassium, calcium, creatinine, uric acid, and blood urea nitrogen were normal. Results of a cortisol-releasing hormone test suggested hypothalamic damage. Atrial natriuretic peptide and brain natriuretic peptide