Hypertonic Saline: Safe therapy for Children with Acute Brain Insult in Emergency Department of Low and Middle Income Country
Journal Title: Journal Of Pediatric Critical Care - Year 2017, Vol 4, Issue 1
Abstract
Background Hypertonic saline (HTS) has been used for some years to treat elevated intracranial pressure in children in high income countries. There is limited safety data from low and middle income countries. Objective The primary objective of this study was to assess the response and safety of intr avenous administration of hypertonic saline in children with acute brain injury presenting to the pediatric emergency department (PED) of Aga Khan University Hospital (AKUH). The secondary outcomes were changes in outcome - predictive physiological paramet ers. Methods A retrospective, chart review of children who received intravenous HTS in the pediatric emergency department to treat acute brain injury (ABI). Result From January 2013 to December 2013, 216 children received intravenous bolus of 3% HTS as pa rt of their initial management in the PED. The median age of the patients was 6.1 years (1 month to 16 years) and a median dose of 5 mL/kg with 98% of doses given via peripheral line between 30 minutes to one hour. Diagnosis included traumatic brain injury in 110 patients (50.9%) and non - traumatic injury 106 (49.1%) including CNS infection (43.4%), intracranial bleeding (7.5%), acute hepatic failure (10.4%), diabetic ketoacidosis with altered mental status (4.7%). Clinical indications included: depressed co nsciousness (75.5%), seizures (24%) and shock (0.5%). It is safe no adverse events in any child. Significant improvement was observed in heart rate (p= 0.000) and GCS (0.001) after 3% HTS therapy. Conclusions We found 3% HTS was safe in children with acute brain injury traumatic or non – traumatic brain injury.
Authors and Affiliations
Nadia Mohammad, Surraiya Banu, Nick Brown, Sidra Kaleem, Saleem Akhtar, Anwar - ul - Haq
Keywords
Related Articles
- EP ID EP334246
- DOI 10.21304/2017.0401.00156
- Views 110
- Downloads 0
High Flow Nasal Cannula: The New Mode of NIV in Pediatrics : A Working Protocol
.
Fluids in Acute Kidney Injury
Early restoration of euvolemia is the initial step in the management of critically ill children and is important for preventing acute kidney injury(AKI). Isotonic crystalloids are the preferred solutions for fluid resusc...
Prognostic Factors And Outcome Of Pediatric Allogeneic Hematopoietic Stem Cell Transplant Patients Admitted In Intensive Care Unit
.
Monitoring Tissue Perfusion in Shock From Physiology to the Bedside
.
Enteric fever
Enteric fever is a major public health problem especially for India due to poor sanitation, lack of clean drinking water and poor food hygiene. It can affect all age groups, but recent shift towards infants and young chi...