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Variable change in renal function by hypertonic saline.

Jesse J Corry1, Panayiotis Varelas1, Tamer Abdelhak1

  • 1Jesse J Corry, Panayiotis Varelas, Tamer Abdelhak, Stacey Morris, Marlisa Hawley, Allison Hawkins, Department of Neurology, Henry Ford Hospital, Marshfield, WI 54449, United States.

World Journal of Critical Care Medicine
|June 4, 2014
PubMed
Summary
This summary is machine-generated.

Hypertonic saline (HS) use in neurocritical care shows varied effects on renal function. Creatinine levels correlate with sodium and chloride in specific patient groups, suggesting tailored approaches are needed.

Keywords:
Acute kidney injuryCerebral edemaCritical careHypertonic saline solutionSodium chloride

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Area of Science:

  • Neurosurgery
  • Nephrology
  • Critical Care Medicine

Background:

  • Hypertonic saline (HS) is utilized in neurocritical care for managing intracranial pressure.
  • The impact of different HS formulations and patient diagnoses on renal function requires further elucidation.

Purpose of the Study:

  • To investigate the effects of hypertonic saline on renal function in neurocritical care patients.
  • To analyze correlations between serum electrolytes, HS formulations, and creatinine levels based on diagnoses.

Main Methods:

  • Retrospective and prospective review of 1329 neurocritical care patients treated with HS since 2005.
  • Comparison of creatinine changes, HS formulations (3% NaCl, 3% NaCl/sodium acetate, 23.4% NaCl), and diagnoses against normal saline or lactated Ringer's use.

Main Results:

  • Significant differences in severity scores (APACHE II, GCS) were observed across different HS formulations.
  • No overall correlation between chloride (Cl(-)) or sodium (Na(+)) and creatinine (Cr) was found.
  • Dichotomized by diagnosis, moderate correlation between Na(+) and Cr in Traumatic Brain Injury (TBI) (0.45), weak correlations in stroke patients, and weak correlation between Cl(-) and Cr in other populations (0.29) were noted.

Conclusions:

  • Creatinine levels correlate with Na(+) or Cl(-) in stroke and TBI patients, and Cl(-) in other neurocritical care populations.
  • Further prospective studies are necessary to confirm the relationship between HS administration and renal function.