the relationship between serum sodium and intracranial pressure when using hypertonic saline to target mild hypernatremia in patients with head trauma血清钠和颅内压的关系当使用高渗盐水针对轻微头部外伤患者血钠过多.pdfVIP
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the relationship between serum sodium and intracranial pressure when using hypertonic saline to target mild hypernatremia in patients with head trauma血清钠和颅内压的关系当使用高渗盐水针对轻微头部外伤患者血钠过多
Wells et al. Critical Care 2012, 16:R193
/content/16/5/R193
RESEARCH Open Access
The relationship between serum sodium and
intracranial pressure when using hypertonic
saline to target mild hypernatremia in patients
with head trauma
1* 2 2 3 2
Diana L Wells , Joseph M Swanson , G Christopher Wood , Louis J Magnotti , Bradley A Boucher ,
3 2 4 3
Martin A Croce , Charles G Harrison , Michael S Muhlbauer and Timothy C Fabian
Abstract
Introduction: Limited data suggest mild hypernatremia may be related to lower intracranial pressure (ICP) in
patients with traumatic brain injury (TBI). The practice at the study center has been to use hypertonic saline (HTS)
to generate a targeted serum sodium of 145 to 155 mEq/l in patients with TBI. The purpose of this study was to
determine the relationship between serum sodium values and ICP, and to evaluate the acute effect of HTS on ICP.
Methods: A retrospective review of patients who were admitted to the trauma ICU for TBI, had an ICP monitor placed,
and received at least one dose of HTS between January 2006 and March 2011 was performed. Data were collected for
up to 120 hours after ICP monitor placement. The primary outcome was the relationship between serum sodium and
maximum ICP. Secondary outcomes were the relationship between serum sodium and the mean number of daily
interventions for ICP control, and the acute effect of HTS on ICP during the 6 hours after each dose. Linear regression
was used to analyze the primary outcome. Analysis of variance on ranks and repeated measures analysis of variance
were used to evaluate the number of interventions and the
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