The safety of intravenous peripheral administration of 3% hypertonic saline: A systematic review and meta-analysis

Madieh, Jomana; Hasan, Bashar; Khamayseh, Iman; Hrizat, Alaa; SALAH, TAREQ; Nayfeh, Tarek; Gharaibeh, Kamel A.; Hamadah, Abdurrahman

doi:10.1016/j.amjms.2023.04.025

Cited by 7 publications

(1 citation statement)

References 25 publications

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“…As a result, HS infusions are often given via a central vein and under close monitoring in high-dependency or intensive care units [ 83 ]. Although some studies suggest that peripheral administration of HS is safe, [ 84 ] it is not a routine practice.…”

Section: Salt Supplements and Hypertonic Salinementioning

confidence: 99%

Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions—Part II: Combination Therapy

J.J,

J.G.F,

A.L

2024

Curr Heart Fail Rep

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Purpose of Review Fluid retention or congestion is a major cause of symptoms, poor quality of life, and adverse outcome in patients with heart failure (HF). Despite advances in disease-modifying therapy, the mainstay of treatment for congestion—loop diuretics—has remained largely unchanged for 50 years. In these two articles (part I: loop diuretics and part II: combination therapy), we will review the history of diuretic treatment and current trial evidence for different diuretic strategies and explore potential future directions of research. Recent Findings We will assess recent trials, including DOSE, TRANSFORM, ADVOR, CLOROTIC, OSPREY-AHF, and PUSH-AHF, and assess how these may influence current practice and future research. Summary There are few data on which to base diuretic therapy in clinical practice. The most robust evidence is for high-dose loop diuretic treatment over low-dose treatment for patients admitted to hospital with HF, yet this is not reflected in guidelines. There is an urgent need for more and better research on different diuretic strategies in patients with HF.

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Section: Salt Supplements and Hypertonic Salinementioning

confidence: 99%

Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions—Part II: Combination Therapy

J.J,

J.G.F,

A.L

2024

Curr Heart Fail Rep

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Evaluation and Management of Hyponatremia in Heart Failure

Mondellini,

Verbrugge

2024

Curr Heart Fail Rep

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Safety and Effect on Intracranial Pressure of 3% Hypertonic Saline Bolus Via Peripheral Intravenous Catheter for Neurological Emergencies

Khasiyev,

Hakoun,

Christopher

et al. 2024

Neurocrit Care

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Background:Elevated intracranial pressure (ICP) is a neurological emergency in patients suffering from acute brain injuries. Such a state requires immediate and effective interventions to prevent potential neurological deterioration. Current clinical guidelines recommend hypertonic saline (HTS) and mannitol as rst-line therapeutic agents. Notably, HTS is conventionally administered through central venous catheters (CVC), which may introduce delays in treatment due to the complexities associated with CVC placement. These delays can critically affect patient outcomes, necessitating the exploration of more rapid therapeutic avenues. This study aimed to investigate the safety and e cacy of administering rapid boluses of 3% HTS via peripheral intravenous (PIV) catheters. Methods:A retrospective cohort study was performed on patients admitted to SSM Health Saint Louis University Hospital from March 2019 to September 2022 who received at least one 3% HTS bolus via PIV at a rate of 999 mL/hour for neurological emergencies. Outcomes assessed included complications related to 3% HTS bolus and its therapeutic effects as determined by changes in ICP, sodium, chloride, and serum osmolality. Results:Out of 216 3% HTS boluses administered in 124 patients, complications occurred in 8 administrations (3.7%). Pain at injection site (4 administrations; 1.9%) and thrombophlebitis (3 administrations; 1.4%) were most common. The median ICP reduced by 4.6 mmHg after 3% HTS bolus, with signi cant increases in serum sodium, chloride and osmolality (all p < 0.001). Conclusions:Rapid bolus of 3% HTS via PIV presents itself as a relatively safe and e cacious approach, with a compellingly low rate of complications. Its implementation could provide an invaluable alternative to the traditional CVC-based administration, potentially minimizing CVC-associated complications and expediting life-saving interventions for patients with neurological emergencies.

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The safety of intravenous peripheral administration of 3% hypertonic saline: A systematic review and meta-analysis

Cited by 7 publications

References 25 publications

Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions—Part II: Combination Therapy

Diuretic Treatment in Patients with Heart Failure: Current Evidence and Future Directions—Part II: Combination Therapy

Evaluation and Management of Hyponatremia in Heart Failure

Safety and Effect on Intracranial Pressure of 3% Hypertonic Saline Bolus Via Peripheral Intravenous Catheter for Neurological Emergencies

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