Arieff et al, conducted a prospective clinical case study of 16 children and reviewed 24,412 children admitted for surgery. The main objective was to find out whether hyponatremia causes permanent brain damage or not. Over a period of 6 years, 16 children admitted in 5 tertiary hospitals and 9 community hospitals developed hyponatremia within 5 days of admission. At admission the sodium levels were 138 mmol/l. Patients became progressively lethargic, complained of nausea and vomiting after 2 hours of hypotonic fluid infusion. After 37 hours serum sodium was 115 mmol/l and urine osmolality was 676 mmol/kg. Among 16 patients, one was mentally retarded, 10 died and 5 were in permanent vegetative state. Four patients treated with IV sodium chloride (154 mmol/l and 512 mmol/l) showed an increase in sodium level from 108 to 138 mmol/l in 44 hours. Among 24,412 patients 83 patients developed postoperative hyponatremia out of which 7 died.