Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 11 , ISSUE 1 ( January-April, 2022 ) > List of Articles

Perspectives

Prophylactic Infusion of 3% Saline in Intracranial Hypertension: Look before you Leap

Alfonso I Pacheco-Hernandez

Keywords : Neurocritical care, Neurointensive care, Traumatic brain injury

Citation Information : Pacheco-Hernandez AI. Prophylactic Infusion of 3% Saline in Intracranial Hypertension: Look before you Leap. Panam J Trauma Crit Care Emerg Surg 2022; 11 (1):66-67.

DOI: 10.5005/jp-journals-10030-1378

License: CC BY-NC 4.0

Published Online: 24-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Intracranial hypertension can be a direct cause of mortality in neurointensive care. One of the strategies that have proven effective is the use of hyperosmolar fluid therapy to reduce intracranial pressure. The preference for hypertonic saline solution over mannitol has been due to the potential complications of the mannitol. These complications include renal injury and rebound intracranial hypertension. This use of hypertonic saline is sometimes used as a prophylactic administration in anticipation of cerebral insult. Administration of hypertonic saline can be bolus or continuous infusion. There are certain issues that need to be mentioned in the planning of the care. Here, we would like to visit the need for this prophylactic infusion or protocol for hypertonic saline.


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  1. Rossong H, Hasen M, Ahmed B, et al. Hypertonic saline for moderate traumatic brain injury: a scoping review of impact on neurological deterioration. Neurotrauma Rep 2020;1(1):253–260. DOI: 10.1089/neur.2020.0056
  2. Aviram A, Pfau A, Czaczkes JW, et al. Hyperosmolality with hyponatremia, caused by inappropriate administration of mannitol. Am J Med 1967;42(4):648–650. DOI: 10.1016/0002-9343(67)90066-6
  3. Dorman HR, Sondheimer JH, Cadnapaphornchai P. Mannitol-induced acute renal failure. Medicine (Baltimore) 1990;69(3):153–159. DOI: 10.1097/00005792-199005000-00003
  4. Fanous AA, Tick RC, Gu EY, et al. Life-threatening mannitol-induced hyperkalemia in neurosurgical patients. World Neurosurg 2016;91:672.e5–672.e9. DOI: 10.1016/j.wneu.2016.04.021
  5. Diringer MN. The evolution of the clinical use of osmotic therapy in the treatment of cerebral edema. Acta Neurochir Suppl 2016;121:3–6. DOI: 10.1007/978-3-319-18497-5_1
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