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Seguridad del cloruro de sodio 23.4% administrado perifericamente
Christian R Silva1, Jessica Nagy2, Andrew R Zullo2,3
1Rhode Island Hospital, Brown University Health, Providence, RI, USA. Csilva15@brownhealth.org.
Neurocritical care
|August 21, 2025
Resumen
La administración periférica de cloruro sódico al 23,4% es segura para el tratamiento del aumento de la presión intracraneal. Esta terapia hiperosmolar mostró una baja tasa de extravasación sin lesiones significativas en el paciente, aunque la diabetes aumenta el riesgo.
Área de la Ciencia:
- Medicina de cuidados intensivos
- Medicina de emergencia
- Nefrología
Sus antecedentes:
- El tratamiento hiperosmolar con cloruro de sodio al 23,4% es crucial para controlar el aumento de la presión intracraneal.
- La colocación de un catéter venoso central puede retrasar el tratamiento y empeorar los resultados del paciente.
- La administración intravenosa periférica (IV) ofrece una alternativa potencialmente más rápida.
Objetivo del estudio:
- Evaluar la seguridad y eficacia de la administración de cloruro de sodio al 23,4% a través de catéteres periféricos intravenosos.
- Evaluar la incidencia de la extravasación y las lesiones asociadas al paciente.
Principales métodos:
- Estudio de cohorte de observación retrospectiva en dos centros hospitalarios.
- Incluidos los pacientes adultos que recibieron cloruro de sodio al 23,4% por vía periférica.
- Se excluyeron los pacientes con mortalidad o alta dentro de las 24 horas posteriores a la administración.
Principales resultados:
- Se observó una baja tasa de extravasación (6,4%) en 863 administraciones.
- No se han notificado casos de necrosis tisular ni intervenciones quirúrgicas.
- La diabetes mellitus fue identificada como un factor de riesgo, aumentando el riesgo de extravasación en 2,39 veces.
Conclusiones:
- La administración periférica intravenosa de cloruro de sodio al 23,4% es una opción segura con un riesgo mínimo de lesión.
- La identificación temprana de los pacientes con diabetes es importante para mitigar los riesgos de extravasación.
Palabras clave:
Edema en el cerebroSoluciones salinas hipertónicasPresión intracranealCateterismo periféricoLesiones cerebrales traumáticasMás Videos Relacionados
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