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Review article: hypertonic saline use in the emergency department
Colin J Banks1, Jeremy S Furyk
1Emergency Department, The Townsville Hospital, Douglas, Queensland, Australia. felix@uni-greifswald.de
Emergency Medicine Australasia : EMA
|May 9, 2008
Summary
Hypertonic saline (HS) is a recommended alternative to mannitol for treating traumatic brain injury with raised intracranial pressure. It is also advised for severe hyponatremia and certain toxicities, but not for hypovolemic resuscitation.
Area of Science:
- Emergency Medicine
- Nephrology
- Toxicology
Background:
- Hypertonic saline (HS) use is expanding in emergency medicine.
- Evidence review needed for HS applications and recommendations.
Purpose of the Study:
- Review evidence for HS in emergency medicine.
- Develop recommendations for HS use.
Main Methods:
- Literature review of HS solutions.
- Evidence synthesis for clinical recommendations.
Main Results:
- HS recommended for raised intracranial pressure (alternative to mannitol) in traumatic brain injury.
- HS recommended for severe symptomatic hyponatremia.
- HS considered for tricyclic antidepressant toxicity and pediatric diabetic ketoacidosis cerebral edema.
- HS not recommended for hypovolemic resuscitation.
Conclusions:
- HS offers valuable therapeutic options in emergency medicine.
- Specific indications and contraindications for HS require clear guidelines.
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