Hypertonic salt solution for peri-operative fluid management

Shrum, Brad; Church, Brian T.; McArthur, Eric; Burns, Karen E. A.; Znajda, Tammy; McAlister, Vivian C.

doi:10.1002/14651858.cd005576.pub3

Cited by 10 publications

(7 citation statements)

References 45 publications

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“…This may result in central pontine myelinolysis, metabolic depression, AKI and congestive cardiac failure. Except for a statistically significant rise in the postoperative serum sodium at the 12th and 24th h, and stoppage of the infusion in one patient intraoperatively, there were no adverse effects related to the administration of 3% HTS, further outlining its safety in this cohort of patients, which are similar to the results obtained in previous studies [6, 13].…”

Section: Discussionsupporting

confidence: 87%

“…A recent study showed that a difference of 550 ml of intraoperative fluid results in a higher incidence of complications in the group with more positive fluid balance [8]. The mean difference between patients receiving HTS and isotonic solutions is around 910 ml [6]. So, we hypothesized that the use of 3% HTS will reduce the intraoperative maintenance fluid requirement by at least 500 ml as compared to 0.9% normal saline (NS).…”

Section: Introductionmentioning

confidence: 99%

“…Three percent hypertonic saline (3% HTS) is used in patients undergoing neurosurgery as an anti‐edema measure to decrease the intracranial pressure. It acts like an osmotic buffer and draws water from the interstitial into the intravascular space [6]. The benefits of 3% HTS were shown in the HYSLAR trial [7], whereby there was decreased incidence of postoperative complications in patients undergoing pancreatico‐duodenectomy who received 3% HTS.…”

Section: Introductionmentioning

confidence: 99%

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Influence of 3% Hypertonic Saline Versus 0.9% Saline on Intraoperative Maintenance Fluid Requirements in Adult Patients Undergoing Major Open Abdominal Surgeries: Randomized Controlled Study

2022

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Background Three percent hypertonic saline (3% HTS) acts like an osmotic buffer and draws fluid from the extracellular space into the intravascular compartment. Primary objective was to evaluate whether use of 3% HTS resulted in a difference in intraoperative maintenance fluid requirement versus 0.9% saline (NS). Secondary objectives were to evaluate differences in 24 h fluid requirements and safety of 3% HTS. Methods Adult patients of either sex, 18-65 years, undergoing elective major open abdominal surgeries were randomized to receive infusions of 3% HTS or NS at 1 ml/kg/hr through large bore peripheral i.v cannulas, or central venous catheters after anesthesia induction. Intraoperative maintenance fluids were administered to maintain mean arterial pressure (C70 mmHg), urine output (C0.5 ml/kg/hr) and central venous pressure of 8-10 cm H 2 O. Results Ninety-three patients completed the study (46 in 3% HTS and 47 in NS group). No difference was seen in the volume of intraoperative maintenance fluids (3% HTS vs NS; 2243.9 ± 896.7 ml vs 2093.6 ± 868.7 ml; P = 0.34). Similarly, the 24 h postoperative fluid requirement was not different (3% HTS vs NS; 2006.6 ± 398.6 ml vs 2018.3 ± 389.3 ml; P = 0.94). Patients in 3% HTS group had statistically but not clinically significant higher serum sodium values at postoperative 12th and 24 h. No complication like thrombophlebitis or tissue ischemia was reported due to administration of 3% HTS through peripheral lines. Conclusion Administration of 3% HTS did not reduce intraoperative maintenance fluid requirements in patients undergoing major open abdominal surgeries. Trial registration CTRI/2019/09/021032.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Influence of 3% Hypertonic Saline Versus 0.9% Saline on Intraoperative Maintenance Fluid Requirements in Adult Patients Undergoing Major Open Abdominal Surgeries: Randomized Controlled Study

2022

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“…Furthermore, hypertonic saline is effectual in the resuscitation of patients with hypovolemic shock [ 7 , 8 ]. It is also an alternative for volume preloading before anesthesia [ 9 ], and for perioperative fluid management [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Lidocaine coinfusion alleviates vascular pain induced by hypertonic saline infusion: a randomized, placebo-controlled trial

et al. 2021

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Background Hypertonic saline solution has been frequently utilized in clinical practice. However, due to the nonphysiological osmolality, hypertonic saline infusion usually induces local vascular pain. We conducted this study to evaluate the effect of lidocaine coinfusion for alleviating vascular pain induced by hypertonic saline. Methods One hundred and six patients undergoing hypertonic saline volume preloading prior to spinal anesthesia were randomly allocated to two groups of 53 each. Group L received a 1 mg/kg lidocaine bolus followed by infusion of 2 mg/kg/h through the same IV line during hypertonic saline infusion; Group C received a bolus and infusion of normal saline of equivalent volume. Visual analogue scale (VAS) scores of vascular pain were recorded every 4 min. Results The vascular pain severity in Group L was significantly lower than that in Group C for each time slot (P < 0.05). The overall incidence of vascular pain during hypertonic saline infusion in Group L was 48.0%, which was significantly lower than the incidence (79.6%) in Group C (P < 0.05). Conclusion Lidocaine coinfusion could effectively alleviate vascular pain induced by hypertonic saline infusion. Trial registration Chinese Clinical Trial Registry, number: ChiCTR1900023753. Registered on 10 June 2019.

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“…The review collected primary outcome data on mortality and serious adverse events. Secondary outcomes included fluid balance over the study period, total volume of intravenous fluid delivered (during perioperative and recovery period), perioperative diuresis, maximum and final serum sodium concentration, durations of postoperative stay in both intensive care and in hospital, serum osmolarity and intraoperative measures of cardiac function if they were reported in the study (Shrum et al 2016).…”

Section: Objectivesmentioning

confidence: 99%

Hypertonic salt solution for perioperative fluid management

Govind

2018

Journal of Perioperative Practice

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This is a summary of a Cochrane Review. The full citation and the names of the researchers who conducted the review are listed in the reference section below. The Mission of the Cochrane Nursing Care Field (CNCF) is to improve health outcomes through increasing the use of the Cochrane Library and supporting Cochrane's role by providing an evidence base for nurses and related healthcare professionals involved in delivering, leading or researching nursing care. The CNCF produces 'Cochrane Corner' columns (summaries of recent nursing-care-relevant Cochrane Reviews) that are regularly published in collaborating nursing care-related journals. Information on the processes this Field has developed can be accessed at: http://cncf.cochrane.org/evidence-transferprogram-review-summaries

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Hypertonic salt solution for peri-operative fluid management

Abstract: A new author has been added to the review team (Brad Shrum). We added three new studies which did not change the conclusions of the review. We updated the methods for the review.

Cited by 10 publications

References 45 publications

Influence of 3% Hypertonic Saline Versus 0.9% Saline on Intraoperative Maintenance Fluid Requirements in Adult Patients Undergoing Major Open Abdominal Surgeries: Randomized Controlled Study

Influence of 3% Hypertonic Saline Versus 0.9% Saline on Intraoperative Maintenance Fluid Requirements in Adult Patients Undergoing Major Open Abdominal Surgeries: Randomized Controlled Study

Lidocaine coinfusion alleviates vascular pain induced by hypertonic saline infusion: a randomized, placebo-controlled trial

Hypertonic salt solution for perioperative fluid management

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