[P3-98] Outcome of Hypertonic Saline Treatment in Children with Increased Intracranial Pressure
[Background] mannitol is commonly used as a standard protocol for treatment of intracranial hypertension. Several studies had reported minimized side effects and a better outcome, using the hypertonic saline as an alternative drug. While there are very few reports in children, this study is targeting the outcome of hypertonic saline treating intracranial hypertension in children.
[Methods] this retrospective study performed in Maharat Nakhon Ratchasima Hospital during 1 February 2014 to 31 February 2016. Patients’ age between 1 month and 15 years with increased intracranial pressure (diagnosed by clinical and/or radiological findings) received 3% hypertonic saline (HS) 4-6 ml/kg bolus 1 hour followed by continuous drip 1-2 ml/kg/hr. The outcome determined by side effects, short-term mortality (death within 30 days), long-term mortality and morbidities (using Modified Rankin Scale (MRS)).
[Results] 25 patients with mean age of 5+4.66 years, 68% male had received HS infusion at duration of 1 to 96 hours. The etiology of intracranial hypertension was classified as; intracerebral hemorrhage (32%), cerebral ischemia (20%), brain tumor (16%) and CNS infection (32%). Subsequent to HS infusion, serum Na range between 138-158 mmol/L and serum osmolarity range between 292-338 mOsmol/L. Overall mortality was 40% (short-term 36%, long-term 4%). 24% had severe disability and 36 % had mild to moderate disability at 6 months follow up. The side effects of HS were considered to be hypercholemic metabolic acidosis (32%) and hypokalemia (36%).
[Conclusion] hypertonic saline had beneficial effects and good neurological outcomes with no serious adverse results.
[Methods] this retrospective study performed in Maharat Nakhon Ratchasima Hospital during 1 February 2014 to 31 February 2016. Patients’ age between 1 month and 15 years with increased intracranial pressure (diagnosed by clinical and/or radiological findings) received 3% hypertonic saline (HS) 4-6 ml/kg bolus 1 hour followed by continuous drip 1-2 ml/kg/hr. The outcome determined by side effects, short-term mortality (death within 30 days), long-term mortality and morbidities (using Modified Rankin Scale (MRS)).
[Results] 25 patients with mean age of 5+4.66 years, 68% male had received HS infusion at duration of 1 to 96 hours. The etiology of intracranial hypertension was classified as; intracerebral hemorrhage (32%), cerebral ischemia (20%), brain tumor (16%) and CNS infection (32%). Subsequent to HS infusion, serum Na range between 138-158 mmol/L and serum osmolarity range between 292-338 mOsmol/L. Overall mortality was 40% (short-term 36%, long-term 4%). 24% had severe disability and 36 % had mild to moderate disability at 6 months follow up. The side effects of HS were considered to be hypercholemic metabolic acidosis (32%) and hypokalemia (36%).
[Conclusion] hypertonic saline had beneficial effects and good neurological outcomes with no serious adverse results.