he 19-year-old college student, reportedly on a dare, swallowed an entire quart of soy sauce, which sent him into a coma. The Virginia man, whose name was not released, was taken to the University of Virginia Medical Center, where he was treated by Dr. David J. Carlberg.“He didn't respond to any of the stimuli that we gave him,” Carlberg said. “He had some clonus, which is just elevated reflexes. It's a sign that basically the nervous system wasn't working very well.”
The report was published online June 4 in the Journal of Emergency Medicine. According to the report, intentional massive sodium chloride ingestions, despite being rare, are often fatal.
The teen was taken to the hospital emergency room in a comatose state with seizure-like activity approximately two hours after ingesting the quart of soy sauce. The man had a peak serum sodium level in his body of 196 mmol/L (Millimoles per Liter). Normal serum sodium levels are between 135 and 145 mmol/L.
“To our knowledge, [the incident] is the highest documented level in an adult patient to survive an acute sodium ingestion without neurologic deficits,” reported the Journal.
Too much salt in the blood, a condition called hypernatremia, can be life threatening. The body recognizes severely elevated sodium levels and starts to pull water from other vital organs to compensate, including the brain.
Water drawn out of body tissues and organs is forced into the bloodstream as the body tries to offset the high salt concentration. Quickly pulling water from the brain can lead to neurological disorders or death.
At the hospital, dilution of the man’s sodium levels began immediately. Salt was flushed out of his system via solutions of water and sugar dextrose. According to the Journal, when the team placed the nasal tube, streaks of brown material came out. Within a half hour of treatment, 1.5 gallons of sugar water were pumped into the man's body.
Dr. Carlberg credits the teen’s survival because the hospital staff was able to quickly reduce sodium levels before any permanent damage occurred.
“We were more aggressive than had been reported before in terms of bringing his sodium back down to a safer range,” Carlberg said.
The man's sodium levels returned to normal after about five hours but he remained in a coma for three days. Months after the incident, he was back in college, but perhaps he will forgo the Chinese take-out for a few semesters.
