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Related Experiment Videos

Hypertonic saline: a clinical review.

R Tyagi1, K Donaldson, C M Loftus

  • 1Department of Neurological Surgery, Temple University, 3401 N. Broad St., Suite C540, Philadelphia, PA 19140, USA.

Neurosurgical Review
|June 19, 2007
PubMed
Summary
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Hypertonic saline (HTS) effectively controls intracranial pressure (ICP) in inpatients and aids resuscitation in traumatic brain injury (TBI). Its role in prehospital trauma resuscitation remains uncertain, requiring further study.

Area of Science:

  • Critical Care Medicine
  • Neuroscience
  • Emergency Medicine

Background:

  • Hypertonic saline (HTS) solutions, with sodium chloride concentrations exceeding 0.9%, are explored for managing elevated intracranial pressure (ICP) and as resuscitative agents.
  • These applications are particularly relevant in settings like traumatic brain injury (TBI) and shock resuscitation.

Purpose of the Study:

  • This review discusses the mechanisms of action, adverse effects, and current clinical evidence regarding HTS.
  • It aims to clarify the role of HTS in managing elevated ICP and in resuscitation protocols.

Main Methods:

  • The review synthesizes findings from existing literature, including clinical studies and a specific randomized Australian trial.
  • It examines evidence related to HTS administration in TBI resuscitation and ICP management across various etiologies.

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Main Results:

  • Studies indicate HTS improves neurological outcomes when administered during TBI resuscitation.
  • HTS demonstrates positive effects on elevated ICP and in shock resuscitation.
  • However, a prehospital trauma resuscitation study found no significant differences in fluid administration, ICP control, or neurological outcomes with aggressive HTS protocols.

Conclusions:

  • HTS appears safe and effective for controlling elevated ICP during inpatient care.
  • The utility of HTS in prehospital trauma resuscitation is yet to be definitively established.
  • Further research and direct protocol comparisons are needed to standardize HTS dosing and administration for optimal patient care.