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Fixed Volume or Fixed Pressure: A Murine Model of Hemorrhagic Shock
Published on: June 6, 2011
Clinical experience using 5% hypertonic saline as a safe alternative fluid for use in trauma
Joseph J DuBose1, Leslie Kobayashi, Alfredo Lozornio
1Division of Trauma, University of Southern California Medical Center, Los Angeles County, Los Angeles, California, USA.
The Journal of Trauma
|May 11, 2010
Summary
This study found that 5% hypertonic saline (HTS) is safe for trauma resuscitation. While it increased sodium levels, no adverse effects were observed, and it may benefit head-injured patients.
Area of Science:
- Trauma Resuscitation
- Emergency Medicine
- Critical Care
Background:
- Limited data on commercially available 5% hypertonic saline (HTS) for resuscitation.
- Previous studies focused on unavailable 7.5% HTS solutions.
Purpose of the Study:
- To compare outcomes of trauma patients receiving 5% HTS with well-matched controls.
- To assess the safety and efficacy of 5% HTS in initial trauma resuscitation.
Main Methods:
- Prospective observational study of 51 trauma patients receiving 5% HTS.
- 1:2 matching of HTS patients to controls based on demographics and injury severity.
- Comparison of laboratory values and clinical outcomes between groups.
Main Results:
- No significant differences in pH, international normalized ratio, or p/f ratios at 8 or 24 hours.
- Elevated serum sodium in HTS group for 3 days without adverse sequelae.
- No difference in mortality; trend towards decreased mortality in head-injured patients.
- Reduced mean ventilator days in the HTS group (7.3 vs. 9.2 days).
Conclusions:
- Commercially available 5% HTS is safe for trauma resuscitation.
- No adverse effects from hypernatremia observed.
- Potential for improved outcomes in selected head-injured trauma patients.
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