[PDF] Hypertonic saline in critical care: a review of the literature and

What is a hypertonic saline bolus?

Hypertonic saline solutions (HTS) are used to treat a variety of neurologic conditions in the ICU. HTS bolus has been shown to be effective in treating increased intra-cranial pressure (ICP) and cerebral edema due to traumatic brain injury, cerebrovascular accident, and aneurysmal hemorrhage.

What should a healthcare professional do when prescribing IV fluids?

•? Skilled and competent healthcare professionals should prescribe and administer IV fluids and assess and monitor patients receiving IV fluids. •? When prescribing IV fluids, remember the five Rs: resuscitation, routine maintenance, replacement, redistribution, and reassessment. •? Offer IV fluid therapy as part of a protocol (see figure):

What should I do if my IV fluid is high in chloride?

•? If patients have received IV fluids containing chloride concentrations >120 mmol/L (such as sodium chloride 0.9%), monitor their serum chloride concentration daily. If patients develop hyperchloraemia or acidaemia, reassess their IV fluid prescription and assess their acid-base status.

Is hypotonic saline a good alternative to normal nS?

Hypotonic saline (those containing D5 ½ NS) can be considered as another alternative to normal saline (NS), however patients may be at higher risk for developing hyponatremia. Patients on the hypovolemic pathway will likely require hypotonic fluid repletion in order to correct their deficits in addition to their ongoing maintenance requirement.