American journal of diseases of children (1960)
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Two schools of thought regarding participation in decision making on critically ill infants have developed. One school places the responsibility for decision making in the hands of a forum, and the other school places it in the hands of the parent and physician. ⋯ From the dialectic developed, there emerges a third alternative that potentially encompasses the needs of all involved participants more fully, especially when participants find themselves confronted with difficult decisions and still unresolved conflict. This third approach is the matrix paradigm.
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Ninety-four well-nourished, bottle-fed infants with hypernatremic (N = 61) or hyponatremic (N = 33) diarrheal dehydration were treated with oral rehydration. In 61 hypernatremic and 25 hyponatremic infants, two thirds of the fluid volume were given as glucose/electrolyte solution containing 90 mmole of sodium per liter and one third as plain water; the other eight hyponatremic infants were given glucose/electrolyte solution alone. ⋯ The mean serum sodium levels fell in the hypernatremic infants to normal and rose in those with hyponatremia. Only five (8%) of the 61 hypernatremic infants manifested convulsions during oral rehydration; this compared favorably with the 14% rate of convulsions encountered previously when we used IV rehydration.