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Abstract
0.003 to 0.049 mmol per liter for benzoic acid and 0.60 to 1.060 mmol per liter for hippuric acid. Since discontinuing the use of bacteriostatic sodium chloride and bacteriostatic water in our nurseries in June 1981, we have seen no further cases of the gasping syndrome. Five additional premature low-birth-weight infants who were hospitalized in the neonatal intensive-care unit after we had stopped using bacteriostatic sodium chloride and bacteriostatic water and who were receiving mechanical ventilation and had umbilical arterial catheters in place were selected at random for blood and urine studies. Central-nervous-system symptoms were also described and ranged from sedation at low doses to convulsions and paralysis at higher doses.7 The neurologic symptoms seen in the present study -- including hypoactivity, hypotonia, coma, and seizure activity -- may have been due to a direct toxic effect of benzyl alcohol on the central nervous system. The clinical features of the gasping syndrome, the relatively large quantities of benzyl alcohol received by these infants, the positive identification of benzyl alcohol and its metabolites in their body fluids, and the known toxic effects of this bacteriostat suggest that benzyl alcohol was involved in the development of the gasping syndrome.