AIM: 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 sin...AIM: 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% Na Cl, 3% Na Cl/sodium acetate mix, and 23.4% Na Cl) 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 GlasgowComa 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.CONCLUSION: 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.展开更多
文摘AIM: 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% Na Cl, 3% Na Cl/sodium acetate mix, and 23.4% Na Cl) 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 GlasgowComa 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.CONCLUSION: 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.
