The Effect of Intravenous Therapy with Hypertonic Saline 5% (HTS) in Patients with High Intracranial Pressure, 24 and 48 Hours after the Surgery

Abstract

Background: Increased intracranial pressure (ICP) can be life-threatening and is associated with poor prognosis. In these patients, mortality rate and life expectancy would increase by reducing the intracranial pressure. Finding appropriate way to reduce pressure without specific changes in blood electrolytes and blood pressure is essential. This study aimed to evaluate the effect of rehydration with hypertonic saline 5% on intraoperative complications and prognosis in patients with high intracranial pressure. Methods: This study was performed on 90 patients with high intracranial pressure undergone surgery. After skin incision, hypertonic saline 5% was injected intravenously. Electrolytes and vital signs of patients at baseline and at 24 and 48 hours after the surgery were compared. The data were analyzed using ANOVA with repeated measures test. Findings: 54 patients (60%) were men and 36 (40%) were women, with the mean age of 48.1 ± 9.8 years. Administration of hypertonic saline significantly increased sodium level (137.5 to 144.9 mmol/l), potassium level (3.8 to 4.96 mmol/l), the amount of output (1.43 to 3.94 l), systolic blood pressure (104.6 to 127.32 mmHg), diastolic blood pressure (61.58 to 85.13 mmHg) and anion gap (9.34 to 18.8) (P < 0.001 for all). Conclusion: This study showed that the use of hypertonic saline 5% serum in patients with high intracranial pressure who need surgery, improve the electrolyte and vital signs, especially blood pressure, which increases the quality of treatment and consequently reduces mortality rate of the patients.

Keywords

• Intracranial pressure
• Hypertonic saline
• Prognosis