title: Effectiveness of 7.5% hypertonic saline in children with severe traumatic brain injury.
abstract: Hyperosmolar therapies aim at controlling increased intracranial pressure (ICP) in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the effect of 7.5% hypertonic saline (HTS) on ICP and cerebral perfusion pressure (CPP) in children with severe TBI.
  
  
  
  Medical records of patients 14 years or younger with severe TBI, admitted in the pediatric intensive care unit of "Aghia Sophia" Children's Hospital, Athens, Greece, during 2009 to 2015, and received HTS apart from mannitol were retrospectively reviewed. The ICP and CPP pre-HTS and 30, 60, and 120 minutes post-HTS infusion were evaluated. Furthermore, the presence of adverse effects, the long-term neurological outcome, and survival were recorded.
  
  
  
  Twenty-nine patients requiring in total 136 HTS infusions were analyzed. The ICP was significantly reduced and CPP elevated at 30, 60, and 120 minutes postinfusion; and furthermore, postadministration ICP and CPP were predominantly within acceptable limits. No significant adverse effects were recorded and most of the patients survived, however, one third had severe neurological impairment at 6 months postinjury.
  
  
  
  In our study, 7.5% HTS infusion as a second-tier osmotic therapy was associated with significant reduction of ICP and increase of CPP in children with severe TBI.
authors.affiliation: Pediatric Intensive Care Unit, "Aghia Sophia" Children's Hospital, Athens, Greece. Electronic address: dimitrisrallis@hotmail.com.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Rallis
authors.affiliation: Pediatric Intensive Care Unit, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Poulos
authors.affiliation: Pediatric Intensive Care Unit, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Kazantzi
authors.affiliation: National and Kapodistrian University of Athens, Medical School, MSc "Cardiopulmonary Resuscitation,", Athens, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Chalkias
authors.affiliation: Pediatric Intensive Care Unit, "Aghia Sophia" Children's Hospital, Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kalampalikis
mesh_terms: D000070642:Brain Injuries, Traumatic / Q000188:drug therapy* / Q000401:mortality; D002648:Child; D002662:Child Health Services; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D015600:Glasgow Coma Scale; D006115:Greece; D006760:Hospitalization; D006801:Humans; D015601:Injury Severity Score; D015278:Intensive Care Units, Pediatric; D019586:Intracranial Hypertension / Q000188:drug therapy* / Q000401:mortality; D007427:Intracranial Pressure / Q000187:drug effects; D008297:Male; D008499:Medical Records; D012189:Retrospective Studies; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D012462:Saline Solution, Hypertonic
keywords: Hypertonic saline; Intracranial pressure; Pediatric; Traumatic brain injury