title: Variable change in renal function by hypertonic saline.
abstract: OBJECTIVE
  To investigate the effects of hypertonic saline in the neurocritical care population.
  
  
  METHODS
  We retrospectively reviewed our hospital's use of hypertonic saline (HS) since March of 2005, and prospectively since October 2010. Comparisons were made between admission diagnoses, creatinine change (Cr), and HS formulation (3% NaCl, 3% NaCl/sodium acetate mix, and 23.4% NaCl) to patients receiving normal saline or lactated ringers. The patients (n = 1329) of the retrospective portion were identified. The data presented represents the first 230 patients with data.
  
  
  RESULTS
  Significant differences in Acute Physiology and Chronic Health Evaluation II scores and Glasgow Coma Scale scores occurred between different saline formulations. No significant correlation of Cl(-) or Na(+) with Cr, nor with saline types, occurred. When dichotomized by diagnosis, significant correlations appear. Traumatic brain injury (TBI) patients demonstrated moderate correlation between Na(+) and Cr of 0.45. Stroke patients demonstrated weak correlations between Na(+) and Cr, and Cl(-) and Cr (0.19 for both). Patients receiving HS and not diagnosed with intracerebral hemorrhage, stroke, subarachnoid hemorrhage, or TBI demonstrated a weak but significant correlation between Cl(-) and Cr at 0.29.
  
  
  CONCLUSIONS
  Cr directly correlates with Na(+) or Cl(-) in stroke, Na(+) in TBI, and Cl(-) in other populations. Prospective comparison of HS and renal function is needed.
authors.affiliation: Jesse J Corry, Panayiotis Varelas, Tamer Abdelhak, Stacey Morris, Marlisa Hawley, Allison Hawkins, Department of Neurology, Henry Ford Hospital, Marshfield, WI 54449, United States.
authors.forename: Jesse J
authors.initials: JJ
authors.lastname: Corry
authors.affiliation: Jesse J Corry, Panayiotis Varelas, Tamer Abdelhak, Stacey Morris, Marlisa Hawley, Allison Hawkins, Department of Neurology, Henry Ford Hospital, Marshfield, WI 54449, United States.
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Varelas
authors.affiliation: Jesse J Corry, Panayiotis Varelas, Tamer Abdelhak, Stacey Morris, Marlisa Hawley, Allison Hawkins, Department of Neurology, Henry Ford Hospital, Marshfield, WI 54449, United States.
authors.forename: Tamer
authors.initials: T
authors.lastname: Abdelhak
authors.affiliation: Jesse J Corry, Panayiotis Varelas, Tamer Abdelhak, Stacey Morris, Marlisa Hawley, Allison Hawkins, Department of Neurology, Henry Ford Hospital, Marshfield, WI 54449, United States.
authors.forename: Stacey
authors.initials: S
authors.lastname: Morris
authors.affiliation: Jesse J Corry, Panayiotis Varelas, Tamer Abdelhak, Stacey Morris, Marlisa Hawley, Allison Hawkins, Department of Neurology, Henry Ford Hospital, Marshfield, WI 54449, United States.
authors.forename: Marlisa
authors.initials: M
authors.lastname: Hawley
authors.affiliation: Jesse J Corry, Panayiotis Varelas, Tamer Abdelhak, Stacey Morris, Marlisa Hawley, Allison Hawkins, Department of Neurology, Henry Ford Hospital, Marshfield, WI 54449, United States.
authors.forename: Allison
authors.initials: A
authors.lastname: Hawkins
authors.affiliation: Jesse J Corry, Panayiotis Varelas, Tamer Abdelhak, Stacey Morris, Marlisa Hawley, Allison Hawkins, Department of Neurology, Henry Ford Hospital, Marshfield, WI 54449, United States.
authors.forename: Michelle
authors.initials: M
authors.lastname: Jankowski
keywords: Acute kidney injury; Cerebral edema; Critical care; Hypertonic saline solution; Sodium chloride