The physiological effects of hyperosmolar resuscitation : 5% vs 3% hypertonic saline
Copyright © 2014 Elsevier Inc. All rights reserved..
BACKGROUND: Use of 5% normal saline (NS) is gaining renewed interest. The primary aim of our study was to compare the physiological effects after the administration of different concentrations of hypertonic saline (3% vs 5%NS) in the initial resuscitation of trauma.
METHODS: We performed a retrospective analysis of a prospectively collected database of all trauma patients who received hypertonic saline during initial resuscitation. Medical records were reviewed for serum electrolytes and serum osmolarity, coagulation parameters, complications, and mortality.
RESULTS: A total of 212 patients were included in the study, of which 170 patients received 5%NS and 42 patients received 3%NS. Both groups were similar in age (41.16 ± 19 vs 44.17 + 23.6; P = .45) and ISS score (26 [17 to 29] vs 25 [16 to 27]; P = .6). Mean serum osmolarity (316 ± 20.3 vs 294 ± 22.5; P = .02) and serum sodium levels (143 ± 8.6 vs 137 ± 10.9; P < .001) remained higher in the 5%NS group within 72 hours of admission. The pH was lower in the 5%NS group compared with the 3%NS group at 24 hours (7.29 ± .12 vs 7.33 ± .12; P = .01); however, at 48 and 72 hours (7.40 ± .07 vs 7.41 ± .07; P = .7), no difference was found. There was no difference in blood products requirement (1,734 vs 2,253 mL; P = .11) between the 2 groups.
CONCLUSIONS: The 5%NS has sustained higher serum osmolarity and serum sodium concentration within the first 72 hours without any increase in adverse effects in comparison with 3%NS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2014 |
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| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:208 |
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| Enthalten in: |
American journal of surgery - 208(2014), 5 vom: 28. Nov., Seite 697-702 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Joseph, Bellal [VerfasserIn] |
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| Links: |
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| Themen: |
5% Normal saline |
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| Anmerkungen: |
Date Completed 26.01.2015 Date Revised 10.12.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.amjsurg.2014.01.009 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM239172949 |
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| 100 | 1 | |a Joseph, Bellal |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The physiological effects of hyperosmolar resuscitation |b 5% vs 3% hypertonic saline |
| 264 | 1 | |c 2014 | |
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| 500 | |a Date Completed 26.01.2015 | ||
| 500 | |a Date Revised 10.12.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2014 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Use of 5% normal saline (NS) is gaining renewed interest. The primary aim of our study was to compare the physiological effects after the administration of different concentrations of hypertonic saline (3% vs 5%NS) in the initial resuscitation of trauma | ||
| 520 | |a METHODS: We performed a retrospective analysis of a prospectively collected database of all trauma patients who received hypertonic saline during initial resuscitation. Medical records were reviewed for serum electrolytes and serum osmolarity, coagulation parameters, complications, and mortality | ||
| 520 | |a RESULTS: A total of 212 patients were included in the study, of which 170 patients received 5%NS and 42 patients received 3%NS. Both groups were similar in age (41.16 ± 19 vs 44.17 + 23.6; P = .45) and ISS score (26 [17 to 29] vs 25 [16 to 27]; P = .6). Mean serum osmolarity (316 ± 20.3 vs 294 ± 22.5; P = .02) and serum sodium levels (143 ± 8.6 vs 137 ± 10.9; P < .001) remained higher in the 5%NS group within 72 hours of admission. The pH was lower in the 5%NS group compared with the 3%NS group at 24 hours (7.29 ± .12 vs 7.33 ± .12; P = .01); however, at 48 and 72 hours (7.40 ± .07 vs 7.41 ± .07; P = .7), no difference was found. There was no difference in blood products requirement (1,734 vs 2,253 mL; P = .11) between the 2 groups | ||
| 520 | |a CONCLUSIONS: The 5%NS has sustained higher serum osmolarity and serum sodium concentration within the first 72 hours without any increase in adverse effects in comparison with 3%NS | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Evaluation Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a 5% Normal saline | |
| 650 | 4 | |a Complications | |
| 650 | 4 | |a Hypertonic saline | |
| 650 | 4 | |a Physiological effects | |
| 650 | 4 | |a Serum sodium | |
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| 650 | 7 | |a Sodium |2 NLM | |
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| 700 | 1 | |a Aziz, Hassan |e verfasserin |4 aut | |
| 700 | 1 | |a Snell, Margeaux |e verfasserin |4 aut | |
| 700 | 1 | |a Pandit, Viraj |e verfasserin |4 aut | |
| 700 | 1 | |a Hays, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Kulvatunyou, Narong |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a O'Keeffe, Terence |e verfasserin |4 aut | |
| 700 | 1 | |a Wynne, Julie |e verfasserin |4 aut | |
| 700 | 1 | |a Friese, Randall S |e verfasserin |4 aut | |
| 700 | 1 | |a Rhee, Peter |e verfasserin |4 aut | |
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