Hyperosmolar coma treated with intravenous sterile water. A study of three cases

Arch Intern Med. 1986 May;146(5):945-7.


Three patients with hyperosmolar coma were treated with intravenous isotonic saline, dextrose, and hypotonic saline solutions. The development of pulmonary edema and increasing hypernatremia precluded the further use of sodium solutions, and the presence of severe hyperglycemia made the further use of dextrose solutions undesirable. To provide further solute-free fluid, intravenous sterile water was administered through a central venous catheter. The hyperosmolar state improved, and all patients survived without biochemical evidence of hemolysis or clinical evidence of cerebral edema.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Blood Glucose / analysis
  • Diabetic Coma / therapy*
  • Humans
  • Hyperglycemic Hyperosmolar Nonketotic Coma / etiology
  • Hyperglycemic Hyperosmolar Nonketotic Coma / therapy*
  • Hypotonic Solutions
  • Infusions, Parenteral
  • Male
  • Middle Aged
  • Osmolar Concentration
  • Sodium / blood
  • Water / administration & dosage*
  • Water-Electrolyte Imbalance / complications
  • Water-Electrolyte Imbalance / therapy*


  • Blood Glucose
  • Hypotonic Solutions
  • Water
  • Sodium