HYPERTONIC SALINE THERAPY
Hypertonic saline is administered for a wide variety of conditions, and this multitude of indications can sometimes seem confusing. Currently, there are 3 primary indications for the use of hypertonic saline in critically ill patients:
- hyponatremic states,
- volume resuscitation in shock,
- brain injury and
- Miscellaneous
Hyponatremic states
1. Syndrome of inappropriate antidiuretic hormone (occasionally indicated)
2. Cerebral salt-wasting syndrome (indicated if hyponatremia
is significant)
3. Other causes (rarely indicated)
- Psychogenic polydipsia
- Diuretic overuse/abuse
- Addison disease
- Excessive losses of gastrointestinal secretions
- Late-stage cirrhosis, congestive heart failure, or renal disease
Volume resuscitation in shock (may be beneficial)
- Hemorrhagic shock
- Septic shock
- Major burns
Brain injury (may be beneficial) Traumatic or nontraumatic
Miscellaneous uses
Oral (largely historical)
- Heat-related disorders
- Orthostatic hypotension
- Cystic fibrosis
Parenteral uses
- Sclerotherapy (injected directly into affected vein)
- After coronary artery bypass surgery (intravenous)
- Leishmaniasis (intradermal)
- Midtrimester abortion (intra-amniotic)
Hypertonic Solution (3% NS) in cerebral edema and intracranial hypertension
