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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]
The presence of cerebral edema, or other moderate to severe symptoms, may necessitate intravenous hypertonic saline administration with close monitoring of the serum sodium levels to avoid overcorrection. [2] SIADH was originally described in 1957 in two people with small-cell carcinoma of the lung. [3]
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.
Hypertonic saline and mannitol are the main osmotic agents in use, while loop diuretics can aid in the removal of the excess fluid pulled out of the brain. [1] [3] [7] [43] Hypertonic saline is a highly concentrated solution of sodium chloride in water and is administered intravenously. [3]
If the sodium level is <120 mEq/L, the person can be treated with hypertonic saline as extremely low levels are associated with severe neurological symptoms. [14] In non-emergent situations, it is important to correct the sodium slowly to minimize risk of osmotic demyelination syndrome.
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.
The most commonly used crystalloid fluid is normal saline, a solution of sodium chloride at 0.9% concentration, which is close to the concentration in the blood . [3] Ringer's lactate or Ringer's acetate is another isotonic solution often used for large-volume fluid replacement.