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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).
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]
While they may start out hypertonic they become hypotonic solutions as the sugar is metabolised. [5] Versions are also available mixed with saline. [3] Dextrose solutions for medical use became available in the 1920s and 1930s. [6] [7] It is on the World Health Organization's List of Essential Medicines. [8]
The administration of fluids is slowed. The ideal treatment of cerebral edema in DKA is not established, but intravenous mannitol and hypertonic saline (3%) are used—as in some other forms of cerebral edema—in an attempt to reduce the swelling. [31] Cerebral edema is unusual in adults. [6]
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]
Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein.The intravenous route of administration is commonly used for rehydration or to provide nutrients for those who cannot, or will not—due to reduced mental states or otherwise—consume food or water by mouth.
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.
Hypertonic Saline which contains sodium chloride works in regulating ICP, intravascular volume and cardiac output without causing significant diuresis, but there are theoretical side effects ranging from neurological complications to subdural hematoma. Hypertonic saline solution has been choice of neuro critical care for the past few years. [1]