Clinical experience using 5% hypertonic saline as a safe alternative fluid for use in trauma

Joseph J. Dubose, Leslie Kobayashi, Alfredo Lozornio, Pedro Teixeira, Kenji Inaba, Lydia Lam, Peep Talving, Bernardino Branco, Demetrios Demetriades, Peter M Rhee

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Published experience of hypertonic saline (HTS) use in resuscitation has described the use of commercially unavailable 7.5% solutions. The purpose of this study was to compare our experience with the administration of commercially available 5% HTS solution with that of well-matched controls who did not receive HTS. Methods: Prospective observational study of 51 trauma patients receiving 500 mL of 5% HTS during initial resuscitation. Patients who received HTS were 1:2 matched using age, gender, Injury Severity Score, Coma Score, Head Abbreviated Injury Scale, and injury mechanism to trauma patients who did not receive HTS. The laboratory values and outcomes of the two groups were compared. Results: Patients receiving HTS demonstrated no difference from the matched cohort in mean pH, international normalized ratio, or p/f ratios at 8 hours or 24 hours. The mean serum sodium of the HTS group was higher than controls at 8 hours (143.1 vs. 150.1 mg/dL, p < 0.001) and remained significantly more increased for 3 days without any adverse sequelae related to hypernatremia. No difference in mortality was noted between the two groups. A trend in decreased mortality was observed in patients with Coma Score ≤8 and Head Abbreviated Injury Scale score ≥3 (25.0% vs. 42.5%). The mean ventilator days were 7.3 for HTS group and 9.2 for the non-HTS group. Conclusion: Although serum sodium remained increased for several days after HTS administration, no adverse sequelae as a result of hypernatremia resulted. Commercially available 5% HTS solution is safe for use in the resuscitation of trauma patients and may improve outcomes in a selected subset of patients with head injury.

Original languageEnglish (US)
Pages (from-to)1172-1177
Number of pages6
JournalJournal of Trauma
Volume68
Issue number5
DOIs
StatePublished - May 2010

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Wounds and Injuries
Craniocerebral Trauma
Hypertonic Saline Solutions
Abbreviated Injury Scale
Resuscitation
Hypernatremia
Coma
Sodium
Injury Severity Score
International Normalized Ratio
Mortality
Mechanical Ventilators
Serum
Observational Studies
Prospective Studies

Keywords

  • Fluids
  • Hypernatremia
  • Hypertonic saline
  • Resuscitation
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Clinical experience using 5% hypertonic saline as a safe alternative fluid for use in trauma. / Dubose, Joseph J.; Kobayashi, Leslie; Lozornio, Alfredo; Teixeira, Pedro; Inaba, Kenji; Lam, Lydia; Talving, Peep; Branco, Bernardino; Demetriades, Demetrios; Rhee, Peter M.

In: Journal of Trauma, Vol. 68, No. 5, 05.2010, p. 1172-1177.

Research output: Contribution to journalArticle

Dubose, JJ, Kobayashi, L, Lozornio, A, Teixeira, P, Inaba, K, Lam, L, Talving, P, Branco, B, Demetriades, D & Rhee, PM 2010, 'Clinical experience using 5% hypertonic saline as a safe alternative fluid for use in trauma', Journal of Trauma, vol. 68, no. 5, pp. 1172-1177. https://doi.org/10.1097/TA.0b013e3181d76d40
Dubose, Joseph J. ; Kobayashi, Leslie ; Lozornio, Alfredo ; Teixeira, Pedro ; Inaba, Kenji ; Lam, Lydia ; Talving, Peep ; Branco, Bernardino ; Demetriades, Demetrios ; Rhee, Peter M. / Clinical experience using 5% hypertonic saline as a safe alternative fluid for use in trauma. In: Journal of Trauma. 2010 ; Vol. 68, No. 5. pp. 1172-1177.
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AU - Lam, Lydia

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