Evidence map›Paper›PMID 38379103›Full record

ArticleNeurocritical care2024

Safety and Effect on Intracranial Pressure of 3% Hypertonic Saline Bolus Via Peripheral Intravenous Catheter for Neurological Emergencies.

Farid Khasiyev, Abdullah Hakoun, Kara Christopher, James Braun, Fajun Wang

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Article in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Farid KhasiyevDepartment of Neurology, Saint Louis University, St. Louis, MO, USA.
Abdullah HakounDepartment of Neurology, Saint Louis University, St. Louis, MO, USA.
Kara ChristopherDepartment of Neurology, Saint Louis University, St. Louis, MO, USA.
James BraunDepartment of Pharmacy, Sisters of Saint Mary Health Saint Louis University Hospital, 1008 S. Spring Ave, St. Louis, MO, 63110, USA.
Fajun WangDepartment of Neurology, Saint Louis University, St. Louis, MO, USA. fajun.wang@health.slu.edu.ORCID 0000-0002-0901-341X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElevated intracranial pressure (ICP) is a neurological emergency in patients with acute brain injuries. Such a state requires immediate and effective interventions to prevent potential neurological deterioration. Current clinical guidelines recommend hypertonic saline (HTS) and mannitol as first-line therapeutic agents. Notably, HTS is conventionally administered through central venous catheters (CVCs), which may introduce delays in treatment due to the complexities associated with CVC placement. These delays can critically affect patient outcomes, necessitating the exploration of more rapid therapeutic avenues. This study aimed to investigate the safety and effect on ICP of administering rapid boluses of 3% HTS via peripheral intravenous (PIV) catheters.

methodsA retrospective cohort study was performed on patients admitted to Sisters of Saint Mary Health Saint Louis University Hospital from March 2019 to September 2022 who received at least one 3% HTS bolus via PIV at a rate of 999 mL/hour for neurological emergencies. Outcomes assessed included complications related to 3% HTS bolus and its effect on ICP.

resultsOf 216 3% HTS boluses administered in 124 patients, complications occurred in 8 administrations (3.7%). Pain at the injection site (4 administrations; 1.9%) and thrombophlebitis (3 administrations; 1.4%) were most common. The median ICP reduced by 6 mm Hg after 3% HTS bolus administration (p < 0.001).

conclusionsRapid bolus administration of 3% HTS via PIV catheters presents itself as a relatively safe approach to treat neurological emergencies. Its implementation could provide an invaluable alternative to the traditional CVC-based administration, potentially minimizing CVC-associated complications and expediting life-saving interventions for patients with neurological emergencies, especially in the field and emergency department settings.

Indexed as

Catheterization, PeripheralIntracranial HypertensionAdultAgedBrain InjuriesEmergenciesFemaleHumansIntracranial PressureMaleMiddle AgedRetrospective StudiesSaline Solution, HypertonicSaline Solution, Hypertonic3% hypertonic salineIntracranial pressureNeurological emergenciesPeripheral intravenous catheterSafety

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.