Three-percent saline administration during pediatric critical care transport
Autor: | Grenith Zimmerman, Shamel Abd-Allah, Matthew F. Gross, Alexander Zouros, Farrukh Mirza, Johnny L. Luu, Besh Barcega, Cherry L. Wendtland |
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Rok vydání: | 2011 |
Předmět: |
Male
medicine.medical_specialty Catheterization Central Venous Adolescent Critical Care medicine.medical_treatment Ambulances Brain Edema Intensive Care Units Pediatric Catheterization Peripheral medicine Humans Glasgow Coma Scale Mannitol Child Saline Retrospective Studies Saline Solution Hypertonic Dose-Response Relationship Drug business.industry Sodium Infant Retrospective cohort study General Medicine Sodium blood Infusions Intraosseous Respiration Artificial Radiography Transportation of Patients Brain Injuries Child Preschool Pediatrics Perinatology and Child Health Emergency medicine Emergency Medicine Drug Evaluation Drug Therapy Combination Female Pediatric critical care Intracranial Hypertension business Administration (government) |
Zdroj: | Pediatric emergency care. 27(12) |
ISSN: | 1535-1815 |
Popis: | The purpose of this study was to describe the administration of 3% saline (3%S) during pediatric critical care transport.A retrospective study was performed on pediatric patients who underwent critical transport to Loma Linda University Children's Hospital from January 1, 2003, to June 30, 2007, and were given 3%S. Patients' demographics, admission diagnosis, route and amount of 3%S administration, serum electrolytes, vital signs, radiographic data, and Glasgow Coma Scale scores were collected and analyzed.A total of 101 children who received 3%S infusions during pediatric critical care transport were identified. Mean patient age was 5.9 years, and mean patient weight was 27.6 kg. The main indications for infusing 3%S were suspected cerebral edema (41%), intracranial bleed with edema (51%), and symptomatic hyponatremia (6%). The amount of 3%S bolus ranged from 1.2 to 24 mL/kg, with a mean of 5.4 mL/kg. Serum electrolytes before and after 3%S infusion demonstrated significant increases in sodium, chloride, and bicarbonate levels (P0.05). A significant reduction was also seen in serum urea nitrogen levels and anion gap. Radiographic imaging performed before 3%S infusion demonstrated findings consistent with concerns of increased intracranial pressure such as intracranial bleed and cerebral edema. The route of initial 3%S infusions was mainly through peripheral intravenous lines (96%). No complications related to the 3%S delivery such as local reactions, renal abnormalities, or central pontine myelinolysis were observed.It seems 3%S may be administered safely during pediatric critical transport and administration routes can include peripheral lines. With the importance of initiating therapy early to improve patient outcomes, the use of 3%S may benefit transported children with brain injury and suspected intracranial hypertension. |
Databáze: | OpenAIRE |
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