[P3-99] Preliminary Experiences of Continuous Hypertonic Saline Therapy
in Neurocritically Ill Children
[Background] Osmotherapy with hypertonic saline recently is considered as the golden standard therapy for intracranial hypertension. For pediatric patients with neurocritical illness, the usage of hypertonic saline still remains controversial.
[Methods] During 2013-2016, the patients with clinical manifestations of intracranial hypertension who admitted to PICU of Kaohsiung medical university hospital were retrospectively analyzed. Hypertonic saline (3%) was given continuously with the dose of 0.5-1 milliliter per body weight (kilogram) every hour since admission. Duration and the amount of osmotherapy were adjusted according to the symptoms. Renal function and the level of serum sodium before and after osmotherapy were recorded.
[Results] Total 31 patients (mean age=5.6, SD=6.1) were included. The causes of intracranial hypertension were brain hemorrhage (64.5%, n=20, arteriovenous malformation, subdural hemorrhage, subarachnoid hemorrhage, epidural hemorrhage), brain edema (29%, n=9) and out-hospital cardiac arrest (6.5%, n=2)
Survival rate of the patients is 93.5%. Mean ICU stay of the survivors is 14 days (SD=10.7). The level of serum sodium during osmotherapy were within 130 and 151. No episode of acute renal failure occurred. The level of blood urea nitrogen decreased (p=0.046) and the level of creatinine remains unchanged (p=0.14) after osmotherapy.
[Conclusions] Continuous hypertonic saline shows excellent advantages in controlling intracranial hypertension. The effects of body fluid restoration in hypertonic saline may also prevent acute renal failure.
[Methods] During 2013-2016, the patients with clinical manifestations of intracranial hypertension who admitted to PICU of Kaohsiung medical university hospital were retrospectively analyzed. Hypertonic saline (3%) was given continuously with the dose of 0.5-1 milliliter per body weight (kilogram) every hour since admission. Duration and the amount of osmotherapy were adjusted according to the symptoms. Renal function and the level of serum sodium before and after osmotherapy were recorded.
[Results] Total 31 patients (mean age=5.6, SD=6.1) were included. The causes of intracranial hypertension were brain hemorrhage (64.5%, n=20, arteriovenous malformation, subdural hemorrhage, subarachnoid hemorrhage, epidural hemorrhage), brain edema (29%, n=9) and out-hospital cardiac arrest (6.5%, n=2)
Survival rate of the patients is 93.5%. Mean ICU stay of the survivors is 14 days (SD=10.7). The level of serum sodium during osmotherapy were within 130 and 151. No episode of acute renal failure occurred. The level of blood urea nitrogen decreased (p=0.046) and the level of creatinine remains unchanged (p=0.14) after osmotherapy.
[Conclusions] Continuous hypertonic saline shows excellent advantages in controlling intracranial hypertension. The effects of body fluid restoration in hypertonic saline may also prevent acute renal failure.