What is it about?
The purpose of our study was to assess the efficacy in reducing intracranial pressure, time to administration, and safety of 5% NaCl as compared to 23.4% NaCl for the treatment of intracranial hypertension. Boluses of 5% NaCl are used frequently at our institution to treat intracranial hypertension in patients without central intravenous access to avoid harmful delays in treatment. This product is severely underutilized across the country and has never been formally compared to the current gold-standard hypertonic saline product for osmotic therapy, 23.4% NaCl.
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Why is it important?
Our retrospective study with extensive chart review is the first to directly compare the efficacy and safety of bolus doses of 5% NaCl and 23.4% NaCl for intracranial hypertension.
Perspectives
Our study suggests that 5% NaCl is as effective as 23.4% NaCl at lowering ICP if given at equiosmolar doses, may be favorable to 23.4% NaCl in patients who require a HTS bolus and do not have central venous access, and that bolus doses of 5% NaCl do not incur significant increases in adverse events as compared to 23.4% NaCl. Thus, I promote more widespread use of this product at the equiosmolar dose of 3.22 mL/kg in adult patients that require hypertonic saline for intracranial hypertension, especially in those who do not have central intravenous access.
Dr. Christopher K Carter
SSM Health
Read the Original
This page is a summary of: Efficacy, Safety, and Timing of 5% NaCl Compared With 23.4% NaCl for Osmotic Therapy, Annals of Pharmacotherapy, March 2017, SAGE Publications,
DOI: 10.1177/1060028017701220.
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