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Variable change in renal function by hypertonic saline

World Journal of Critical Care Medicine 2014年第2期3卷 61-67页

作者： Jesse J Corry Panayiotis Varelas Tamer Abdelhak Stacey Morris Marlisa Hawley allison hawkins Michelle Jankowski Department of Neurology Henry Ford Hospital Department of Neurosurgery Henry Ford Hospital Department of Biostatistics Henry Ford Hospital

AIM: To investigate the effects of hypertonic saline in the neurocritical care ***: We retrospectively reviewed our hospital's use of hypertonic saline(HS) since March of 2005, and prospectively since October 2010. Comparisons were made between admission diagnoses, creatinine change(Cr), and HS formulation(3% Na Cl, 3% Na Cl/sodium acetate mix, and 23.4% Na Cl) to patients receiving normal saline or lactated ringers. The patients(n = 1329) of the retrospective portion were identified. The data presented represents the first 230 patients with data. RESULTS: Significant differences in Acute Physiology and Chronic Health Evaluation Ⅱ scores and GlasgowComa Scale scores occurred between different saline formulations. No significant correlation of Cl- or Na+ with Cr, nor with saline types, occurred. When dichotomized by diagnosis, significant correlations appear. Traumatic brain injury(TBI) patients demonstrated moderate correlation between Na+ and Cr of 0.45. Stroke patients demonstrated weak correlations between Na+ and Cr, and Cl- and Cr(0.19 for both). Patients receiving HS and not diagnosed with intracerebral hemorrhage, stroke, subarachnoid hemorrhage, or TBI demonstrated a weak but significant correlation between Cl- and Cr at ***: Cr directly correlates with Na+ or Cl- in stroke, Na+ in TBI, and Cl- in other populations. Prospective comparison of HS and renal function is needed.

关键词： Hypertonic saline solution Sodium chloride Acute kidney injury Cerebral edema Critical care

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