To the Editor.—In the November issue of the Journal (130:1250, 1976) Wadlington et al reported a case study of a 16-month-old infant with heat stroke who suffered residual neurologic damage after therapy. The article suggested that correct therapy should include volume expanders to improve circulation; that these expanders be given rapidly with added sodium bicarbonate if the patient was acidotic. In neither the case report nor the comment were any values of serum electrolytes or blood glucose given. It would be nice to know these values in the child presented in order to evaluate the therapy given and the residual damage.
We reported several cases of heat stroke in children and found severe electrolyte and blood glucose abnormalities.1 These children were found to have hyperglycemia and aketotic hyperosmolar acidosis, with markedly elevated serum sodium levels. By judiciously correcting the hyperosmolar condition, we were able to avoid convulsions and