Key result
Hypertonic saline is an effective treatment for severe hyponatremia and raised intracranial pressure in brain injury, though optimal dosing regimens for less severe indications require further research.
Why the study?
Does hypertonic saline improve management of hyponatremia and raised intracranial pressure in patients with brain injury?
Does hypertonic saline improve management of hyponatremia and raised intracranial pressure in patients with brain injury?
Hypertonic saline is a useful tool for managing raised intracranial pressure and severe hyponatremia in brain injury, though robust evidence is lacking and careful monitoring is required.
Supports cautious use in severe hyponatremia or raised ICP with brain injury; leaves open optimal dosing for milder cases.
Hyponatremia is a well known occurrence in traumatic and non traumatic brain injury which is known to complicate the management, affect the prognosis and increase hospital length of stay. Hypertonic saline is one of the drugs among the clinicians armamentarium in order to combat this complication. However its use is marked with many controversies and myths due to lack of robust evidence and non uniformity of trial protocols. In this review the author attempts to review the use of hypertonic saline in brain injury touching on practical use, indications, limitations and goes on to suggest a practical protocol for hypertonic saline in brain injury with raised intracranial pressure. Data Sources: MEDLINE, MICROMEDEX, The Cochrane database of Systematic Reviews from 1967 through May 2012.
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Sanjith Saseedharan (2015) conducted a review in Brain injury, hyponatremia, and raised intracranial pressure. Hypertonic saline was evaluated. Hypertonic saline is an effective treatment for severe hyponatremia and raised intracranial pressure in brain injury, though optimal dosing regimens for less severe indications require further research.
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