Review article: hypertonic saline use in the emergency department.
Hypertonic saline (HS) is being increasingly used for the management of a variety of conditions, most notably raised intracranial pressure. This article reviews the available evidence on HS solutions as they relate to emergency medicine, and develops a set of recommendations for its use. To conclude, HS is recommended as an alternative to mannitol for treating raised intracranial pressure in traumatic brain injury. HS is also recommended for treating severe and symptomatic hyponatremia, and is worth considering for both recalcitrant tricyclic antidepressant toxicity and for cerebral oedema complicating paediatric diabetic ketoacidosis. HS is not recommended for hypovolaemic resuscitation.
Banks
Colin J
CJ
Emergency Department, The Townsville Hospital, Douglas, Queensland, Australia. felix@uni-greifswald.de
Furyk
Jeremy S
JS
D000328:Adult; D001929:Brain Edema / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D001930:Brain Injuries / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004635:Emergency Medicine / Q000592:standards* / Q000639:trends; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000379:methods; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D019586:Intracranial Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality; D008297:Male; D017410:Practice Guidelines as Topic; D011793:Queensland; D012462:Saline Solution, Hypertonic / Q000009:adverse effects / Q000627:therapeutic use*; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance / Q000187:drug effects; D014947:Wounds and Injuries / Q000175:diagnosis / Q000628:therapy
D012462:Saline Solution, Hypertonic