Tuesday February 28, 2006
Hypertonic Solution (3% NS) in cerebral edema and intracranial hypertension
Q: What is the level of Sodium (Na), you will target if hypertonic solution (3% NS) has been choose as management plan in cerebral edema and intracranial hypertension.
A: 145-155 Meq/L.
Although mannitol with close monitoring of serum osmolality remains mainstay of treatment, no major clinical trial has yet established the use of Hypertonic Solution (3% NS) as standard of treatment in cerebral edema and intracranial hypertension but literature has growingly show its comparable and sustained effect on lowering ICP (Intra-cranial pressure).
Related: Read concise review article here on Spontaneous intracerebral hemorrhage from Dr. Matthew E. Fewel and coll., Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan (Neurosurg. Focus / Volume 15 / October, 2003)
References: Click to get abstract/article (second popup overrides first popup).
1. Use of hypertonic saline solutions in treatment of cerebral edema and intracranial hypertension. Critical Care Medicine. 28(9):3301-3313, September 2000.
2. Treatment of elevated intracranial pressure in experimental intracerebral hemorrhage: Comparison between mannitol and hypertonic saline. Qureshi AI, Wilson DA, Traystman RJ: Neurosurgery 1999; 44: 1055-1064 -via pubmed
3. Hypertonic saline for cerebral edema and elevated intracranial pressure - Cleve Clin J Med. 2004 Jan;71 Suppl 1:S9-13.
4. Introducing Hypertonic Saline for Cerebral Edema: An Academic Center Experience - Neurocritical Care Winter 2004, Volume 1, Issue 4, pps. 435-440
5. Treatment of intracerebral haemorrhage - Lancet Neurology 2005; 4:662-672