Intravenous Hypertonic Saline Use in the Pediatric Emergency Department

Brenkert, Timothy E.; Estrada, Cristina; McMorrow, Sheila P.; Abramo, Thomas J.

doi:10.1097/pec.0b013e31827b54c3

Cited by 31 publications

(19 citation statements)

References 16 publications

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“…8,9 In a retrospective cross-sectional study, Brenkert et al 8 investigated administration of a bolus of 3% sodium chloride solution in 56 pediatric patients at an urban children's hospital, with 87% of doses administered via a peripheral catheter. No patient had indications of phlebitis or local tissue destruction.…”

Section: Resultsmentioning

confidence: 99%

“…Tertiary references suggest administration via a largebore central catheter, although this recommendation is not based on actual safety evaluations in adult patients. 7 Peripheral intravenous administration of 3% sodium chloride solution has been studied in children, and results of a few studies 8,9 have indicated limited safety concerns. Proposed safety concerns associated with peripheral administration of a continuous intravenous infusion of 3% sodium chloride solution include extravasation, phlebitis, tissue ischemia, and venous thrombosis.…”

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confidence: 99%

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Safety of Continuous Peripheral Infusion of 3% Sodium Chloride Solution in Neurocritical Care Patients

et al. 2016

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Background Numerous drug information resources recommend that continuous intravenous 3% sodium chloride solution be administered via a central catheter. Objectives To evaluate the incidence of infusion-related reactions and electrolyte abnormalities in neurocritical care patients treated with continuous intravenous infusion of 3% sodium chloride solution via a peripheral catheter. Methods Data on patients treated with continuous intravenous infusion of 3% sodium chloride solution at 2 academic medical centers were evaluated retrospectively to determine the administration site. Electronic notes on catheter status were reviewed to determine the occurrence of infusion-related reactions. Prespecified thresholds were used to assess electrolyte abnormalities. Results Of 213 patients who had peripheral continuous intravenous infusions of 3% sodium chloride solution, 15 (7%) had infusion-related reactions. Administration was changed to a central catheter in 56 patients (26.3%), but only 5 changes were due to an infusion-related reaction. Most (157 patients, 73.7%) received their entire treatment peripherally, for a median duration of 44 hours, 3 minutes. The most common electrolyte abnormalities were hyperchloremia in 49.3% and hypokalemia in 46.9% of patients. Conclusion Current recommendations that a central catheter is required for continuous intravenous infusion of 3% sodium chloride solution should be reevaluated. Only a few patients who had peripheral infusions had infusion-related reactions. Electrolyte abnormalities occurred frequently with peripheral infusion, but the clinical importance of the abnormalities remains unclear.

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Section: Resultsmentioning

confidence: 99%

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confidence: 99%

Safety of Continuous Peripheral Infusion of 3% Sodium Chloride Solution in Neurocritical Care Patients

et al. 2016

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“…Retrospective studies in the pediatrics population have found that patients who received these infusions peripherally had no evidence of adverse events. 15,16 A noteworthy limitation for these studies was the average durations of infusions under 1 hour, which may not be long enough to observe infusion-related adverse events (IRAEs).…”

Section: Introductionmentioning

confidence: 99%

Incidence of Adverse Events During Peripheral Administration of Sodium Chloride 3%

Dillon

Merchan

Altshuler

et al. 2017

J Intensive Care Med

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“…Hypertonic saline (3% HTS) can be administered via a peripheral inserted catheter [6]. Modern evidence does not support the concern for HTS-induced intravascular hemolysis with peripheral vein administration in humans [7,8].…”

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confidence: 99%

Nephrology key information for internists

Salim

Medaura

Malhotra

et al. 2017

Journal of Community Hospital Internal Medicine Perspectives

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Hospitalists and primary care physicians encounter renal disease daily. Although most cases of acute kidney injury (AKI) are secondary to dehydration and resolve by giving fluids, many cases of AKI are due to not uncommon but unfamiliar causes needing nephrology evaluation. Common indications to consult a nephrologist on an emergency basis include hyperkalemia or volume overload in end stage renal disease patients (ESRD). Other causes of immediate consultation are cresenteric glomerulonephritis / rapidly progressive glomerulonephritis in which renal prognosis of the patient depends on timely intervention. The following evidence-based key information could improve patient care and outcomes.Abbreviations: AKI: Acute kidney injury ESRD: End stage renal disease patients

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Intravenous Hypertonic Saline Use in the Pediatric Emergency Department

Abstract: Intravenous hypertonic saline use is increasing within the pediatric emergency department. Within this institution, it is most frequently used at a dosing range of 3 to 5 mL/kg and does not require central venous access for rapid infusion.

Cited by 31 publications

References 16 publications

Safety of Continuous Peripheral Infusion of 3% Sodium Chloride Solution in Neurocritical Care Patients

Safety of Continuous Peripheral Infusion of 3% Sodium Chloride Solution in Neurocritical Care Patients

Incidence of Adverse Events During Peripheral Administration of Sodium Chloride 3%

Nephrology key information for internists

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