ArticleIrish journal of medical science2015
Single bolus 30% hypertonic saline for refractory intracranial hypertension.
Article in Irish journal of medical science, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations.Intensive care medicine · 2018Guideline
- Traumatic Brain Injury-A Review of Intravenous Fluid Therapy.Frontiers in veterinary science · 2021Review
- Examining the Effect of Hypertonic Saline Administered for Reduction of Intracranial Hypertension on Coagulation.Journal of the American College of Surgeons · 2020Article
- Escalate and De-Escalate Therapies for Intracranial Pressure Control in Traumatic Brain Injury.Frontiers in neurology · 2020Review
- Clinical aspects of symptomatic hyponatremia.Endocrine connections · 2016Review
- Hypertonic saline for the treatment of intracranial hypertension.Current neurology and neuroscience reports · 2014Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn recent years hypertonic saline has attracted increasing interest in the treatment of traumatic intracranial hypertension, and has a number of documented and theoretical advantages over other hyperosmolar agents. To date, no consensus has been achieved on the safest and most effective HTS concentration for administration.
aimsThe purpose of this paper was to evaluate the efficacy of intravenous bolus administration of highly concentrated (30 %) hypertonic saline (HTS) in the treatment of refractory intracranial hypertension secondary to traumatic brain injury.
methodsPatients were treated with an intravenous bolus of 10 ml of 30 % hypertonic saline. Multiple physiological parameters were measured throughout, including intracranial pressure, mean arterial pressure, cerebral perfusion pressure, pulse and inotrope/pressor requirements. Laboratory investigation pre and post HTS administration included: arterial pH, pCO2, HCO3, base excess; serum biochemistry measurements of sodium, potassium, chloride, urea and creatinine; and coagulation studies.
resultsTBI patients saw a rapid and significant reduction in ICP from a baseline value of 28 ± 5.31 to 18.44 ± 6.17 mmHg at 1 h post HTS, a statistically significant reduction that was maintained for up to 7 h. This response was maintained even with repeated HTS administration, which was also associated with an augmented cerebral perfusion pressure from a baseline of 58.0 ± 6.48 to 76.33 mmHg within 1 h of HTS administration.
conclusionNo associated harmful biochemical or haematological abnormalities were noted. In conclusion, highly concentrated 30 % HTS appears to be both effective and safe in the management of refractory intracranial hypertension.
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Registered trials
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