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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]
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).
Mannitol is used intravenously to reduce acutely raised intracranial pressure until more definitive treatment can be applied, [16] e.g., after head trauma. While mannitol injection is the mainstay for treating high pressure in the skull after a bad brain injury, it is no better than hypertonic saline as a first-line treatment.
If there is an intact blood–brain barrier, osmotherapy (mannitol or hypertonic saline) may be used to decrease ICP. [33] It is unclear whether mannitol or hypertonic saline is superior, or if they improve outcomes. [34] [35] Struggling, restlessness, and seizures can increase metabolic demands and oxygen consumption, as well as increasing ...
Central pontine myelinolysis; Other names: Osmotic demyelination syndrome, central pontine demyelination: Axial fat-saturated T2-weighted image showing hyperintensity in the pons with sparing of the peripheral fibers, the patient was an alcoholic admitted with a serum Na of 101 treated with hypertonic saline, he was left with quadriparesis, dysarthria, and altered mental status
[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]
Treatment: Behavioral therapy, speech therapy: A traumatic brain injury (TBI), ... Hypertonic saline can improve ICP by reducing the amount of cerebral water ...
[44] [46] In traumatic brain injuries, a responsiveness to hypertonic saline lasting greater than 2 hours was associated with decreased chance of death and improved neurologic outcomes. [44] The effects of hypertonic saline can be prolonged with combination to agents such as dextran or hydroxyethyl starch , although their use is currently ...
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