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[2] total of 8 mmol per liter during the first day with the use of furosemide and replacing sodium and potassium losses with 0.9% saline. For people with severe symptoms (severe confusion, convulsions, or coma) hypertonic saline (3%) 1–2 ml/kg IV in 3–4 h may be given. [2]
Severe hyponatremia or severe symptoms (confusion, convulsions, or coma): consider hypertonic saline (3%) 1–2 mL/kg IV in 3–4 h. Hypertonic saline may lead to a rapid dilute diuresis and fall in the serum sodium. It should not be used in those with an expanded extracellular fluid volume.
Saline solution for irrigation. Normal saline (NSS, NS or N/S) is the commonly used phrase for a solution of 0.90% w/v of NaCl, 308 mOsm/L or 9.0 g per liter. Less commonly, this solution is referred to as physiological saline or isotonic saline (because it is approximately isotonic to blood serum, which makes it a physiologically normal solution).
Hypertonic saline solution has been choice of neuro critical care for the past few years. [1] Hypertonic Saline solution used varies and could be 3%, 7.5%, 10%, or 24.3% saline solution. [5] When Hypertonic Solution is administered, the dosage is 2 g/kg. [6]
A bolus intravenous dose of 10 or 20 mg of furosemide can be administered and then followed by intravenous bolus of 2 or 3% hypertonic saline to increase the serum sodium level. [ 12 ] Pulmonary edema - Slow intravenous bolus dose of 40 to 80 mg furosemide at 4 mg per minute is indicated for patients with fluid overload and pulmonary edema.
This is due to urea entering the cell down its concentration gradient, followed by water. The osmolarity of normal saline, 9 grams NaCl dissolved in water to a total volume of one liter, is a close approximation to the osmolarity of NaCl in blood (about 290 mOsm/L). Thus, normal saline is almost isotonic to blood plasma.
Volume resuscitation with 0.9% normal saline provides a chloride load, so that infusing more than 3–4L can cause acidosis Hyperalimentation ( i.e. , total parenteral nutrition ) See also
Plasma osmolarity of some reptiles, especial those from a freshwater aquatic environment, may be lower than that of mammals (e.g. < 260 mOsm/L) during favourable conditions. Consequently, solutions osmotically balanced for mammals (e.g., 0.9% normal saline) are likely to be mildly hypertonic for such animals.