title: Safety of Continuous Peripheral Infusion of 3% Sodium Chloride Solution in Neurocritical Care Patients.
abstract: Numerous drug information resources recommend that continuous intravenous 3% sodium chloride solution be administered via a central catheter.
  
  
  
  To evaluate the incidence of infusion-related reactions and electrolyte abnormalities in neurocritical care patients treated with continuous intravenous infusion of 3% sodium chloride solution via a peripheral catheter.
  
  
  
  Data on patients treated with continuous intravenous infusion of 3% sodium chloride solution at 2 academic medical centers were evaluated retrospectively to determine the administration site. Electronic notes on catheter status were reviewed to determine the occurrence of infusion-related reactions. Prespecified thresholds were used to assess electrolyte abnormalities.
  
  
  
  Of 213 patients who had peripheral continuous intravenous infusions of 3% sodium chloride solution, 15 (7%) had infusion-related reactions. Administration was changed to a central catheter in 56 patients (26.3%), but only 5 changes were due to an infusion-related reaction. Most (157 patients, 73.7%) received their entire treatment peripherally, for a median duration of 44 hours, 3 minutes. The most common electrolyte abnormalities were hyperchloremia in 49.3% and hypokalemia in 46.9% of patients.
  
  
  
  Current recommendations that a central catheter is required for continuous intravenous infusion of 3% sodium chloride solution should be reevaluated. Only a few patients who had peripheral infusions had infusion-related reactions. Electrolyte abnormalities occurred frequently with peripheral infusion, but the clinical importance of the abnormalities remains unclear.
authors.affiliation: G. Morgan Jones is a clinical pharmacy specialist, Methodist University Hospital, and an assistant professor of clinical pharmacy, neurology, and neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee. Lauren Bode is a postgraduate year 1 pharmacy resident, University of North Carolina Hospitals and Clinics, Chapel Hill, North Carolina. Heidi Riha is a postgraduate year 2 pharmacy resident, Methodist University Hospital. Michael J. Erdman is a clinical pharmacist, University of Florida Health, Jacksonville, Florida. morgan.jones@mlh.org.
authors.forename: G Morgan
authors.initials: GM
authors.lastname: Jones
authors.affiliation: G. Morgan Jones is a clinical pharmacy specialist, Methodist University Hospital, and an assistant professor of clinical pharmacy, neurology, and neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee. Lauren Bode is a postgraduate year 1 pharmacy resident, University of North Carolina Hospitals and Clinics, Chapel Hill, North Carolina. Heidi Riha is a postgraduate year 2 pharmacy resident, Methodist University Hospital. Michael J. Erdman is a clinical pharmacist, University of Florida Health, Jacksonville, Florida.
authors.forename: Lauren
authors.initials: L
authors.lastname: Bode
authors.affiliation: G. Morgan Jones is a clinical pharmacy specialist, Methodist University Hospital, and an assistant professor of clinical pharmacy, neurology, and neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee. Lauren Bode is a postgraduate year 1 pharmacy resident, University of North Carolina Hospitals and Clinics, Chapel Hill, North Carolina. Heidi Riha is a postgraduate year 2 pharmacy resident, Methodist University Hospital. Michael J. Erdman is a clinical pharmacist, University of Florida Health, Jacksonville, Florida.
authors.forename: Heidi
authors.initials: H
authors.lastname: Riha
authors.affiliation: G. Morgan Jones is a clinical pharmacy specialist, Methodist University Hospital, and an assistant professor of clinical pharmacy, neurology, and neurosurgery, University of Tennessee Health Sciences Center, Memphis, Tennessee. Lauren Bode is a postgraduate year 1 pharmacy resident, University of North Carolina Hospitals and Clinics, Chapel Hill, North Carolina. Heidi Riha is a postgraduate year 2 pharmacy resident, Methodist University Hospital. Michael J. Erdman is a clinical pharmacist, University of Florida Health, Jacksonville, Florida.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Erdman
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D001930:Brain Injuries / Q000628:therapy*; D002561:Cerebrovascular Disorders / Q000628:therapy*; D003422:Critical Care / Q000379:methods*; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage* / Q000009:adverse effects*; D062666:Vascular Access Devices; D014882:Water-Electrolyte Balance
chemical_list: D012462:Saline Solution, Hypertonic