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Subarachnoid Hemorrhage
Researchers from Kaiser Permanente publish findings in subarachnoid hemorrhage
November 6th, 2009
According to a study from the United States, "Hypertonic saline (3% NaCl) infusions can be used to treat acute neurologic hyponatremia (ANH) in critically ill patients with neurological and neurosurgical disorders such as subarachnoid hemorrhage. Adjustments in the rate of hypertonic saline infusions to treat ANH are needed to achieve a goal sodium range and are usually made on an empiric basis." "To date, no data are available to determine how reliably such adjustments achieve stable, normal serum sodium concentrations or how often iatrogenic hypernatremia occurs during the course of treatment with hypertonic saline. We have instituted a standardized sliding-scale hypertonic saline protocol to minimize patient-to-patient variability of hypertonic saline administration and to attempt to achieve safe rates of sodium correction and stable maintenance of serum sodium concentration with minimal overshoot. Here, we present a retrospective analysis of the performance characteristics of our standardized hypertonic saline protocol over a 1-year period, in 49 patients. The mean rate of initial sodium correction was 0.44 +/- A 0.36 (mEq/l)/h. During the maintenance infusion phase, 84.3 +/- A 17.8% of the time was spent in goal range (Na 136-145 mEq/l), 14.9 +/- A 18.1% of the time was spent in mild undershoot (Na 130-135 mEq/l), and 0.7 +/- A 3.1% of the time was spent in overshoot (Na > 145 mEq/l). No adverse events attributable to infusion of hypertonic saline were encountered," wrote C.H. Woo and colleagues, Kaiser Permanente. The researchers concluded: "Our hypertonic saline sliding-scale protocol for treatment of ANH can be used reliably and achieves normal sodium concentrations in a safe manner with minimal overshoot." Woo and colleagues published the results of their research in Neurocritical Care (Performance Characteristics of a Sliding-Scale Hypertonic Saline Infusion Protocol for the Treatment of Acute Neurologic Hyponatremia. Neurocritical Care, 2009;11(2):228-234). For additional information, contact A.C. Flint, Kaiser Permanente, Dept. of Neurosurgery, Kaiser No California Reg Neuroscience Center, 1150 Vet. Blvd., Redwood City, CA 94063, USA. The publisher of the journal Neurocritical Care can be contacted at: Humana Press Inc., 999 Riverview Drive Suite 208, Totowa, NJ 07512, USA. Keywords: United States, Redwood City, Cerebral Hemorrhage, Critical Care, Hypernatremia, Hyponatremia, Nephrology, Neurosurgery, Subarachnoid Hemorrhage, Kaiser Permanente. This article was prepared by NewsRx editors from staff and other reports. Copyright 2009, NewsRx.com.
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