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Hypertonic Saline, Electrolytes, and Insulin

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Abstract

Hypertonic saline, insulin and electrolyte replacement are commonly used in the intensive care unit.1-3 Hypertonic saline has several beneficial effects including ­volume-expanding properties, increased cardiac output, and intracranial pressure reduction.4,5 The electrolytes play a pivotal role in maintaining several metabolic functions and processes.1,6 Appropriate glucose management in the critically ill using insulin infusions has been associated with beneficial outcomes.7-9

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References

  1. Buckley MS, LeBlanc JM, Cawley MJ. Electrolyte disturbances associated with commonly prescribed medications in the intensive care unit. Crit Care Med. 2010;38(6 Suppl):S253-S264.

    Article  PubMed  CAS  Google Scholar 

  2. Froelich M, Quanhong Ni, Wess C, Ougorets I, Härtl R. Continuous hypertonic saline therapy and the occurrence of complications in neurocritically ill patients. Crit Care Med. 2009;37(4):1433-1441.

    Article  PubMed  CAS  Google Scholar 

  3. Gunst J, Van den Berghe G. Blood glucose control in the intensive care unit: benefits and risks. Semin Dial. 2010;23:157-162.

    Article  PubMed  Google Scholar 

  4. Bhardwaj A, Ulatowski A. Hypertonic saline solutions in brain injury. Curr Opin Crit Care. 2004;10:126-131.

    Article  PubMed  Google Scholar 

  5. Strandvik GF. Hypertonic saline in critical care: a review of the literature and guidelines for use in hypotensive states and raised intracranial pressure. Anaesthesia. 2009;64:990-1003.

    Article  PubMed  CAS  Google Scholar 

  6. Kraft MD, Btaiche IF, Sacks GS, et al. Treatment of electrolyte disorders in adult patients in the intensive care unit. Am J Health Syst Pharm. 2005;62:1663-1682.

    Article  PubMed  CAS  Google Scholar 

  7. Van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345:1359-1367.

    Article  PubMed  Google Scholar 

  8. NICE-SUGAR Study Investigators, Finfer S, Chittock DR, Su S, et al. Intensive versus conventional glucose control in critically ill patients. N Engl J Med. 2009;360:1283-1297.

    Article  PubMed  Google Scholar 

  9. Pittas AG, Siegel RD, Lau J. Insulin therapy and in-hospital mortality in critically ill patients: systematic review and meta-analysis of randomized controlled trials. JPEN J Parenter Enteral Nutr. 2006;30:164-172.

    Article  PubMed  CAS  Google Scholar 

  10. Lacherade JC, Jacqueminet S, Preiser JC. An overview of hypoglycemia in the critically ill. J Diabetes Sci Technol. 2009;3:1242-1249.

    PubMed  Google Scholar 

  11. Hashim MK, Issa D, Ahmad Z, Cappuccio JD, Kouides RW, Sterns RH. Hypertonic saline for hyponatremia: risk of inadvertent overcorrection. Clin J Am Soc Nephrol. 2007;2:1110-1117.

    Article  Google Scholar 

  12. Gahart BL, Nazareno AR. Intravenous Medications: A Handbook for Nurses and Health Professionals. 26th ed. St. Louis: Mosby; 2010.

    Google Scholar 

  13. Lacy CF, Armstrong LL, Goldman MP, Lance LL. Drug Information Handbook: A Comprehensive Resource for All Clinicians and Healthcare Professionals. 17th ed. Hudson: Lexi-comp; 2008.

    Google Scholar 

  14. Locatelli F, Pontoriero G, Di Filippo S. Electrolyte disorders and substitution fluid in continuous renal replacement therapy. Kidney Int Suppl. 1998;53:S151-S155.

    Article  Google Scholar 

  15. Soupart A, Penninckx R, Stenuit A, Perier O, Decaux G. Treatment of chronic hyponatremia in rats by intravenous saline: comparison of rate versus magnitude of correction. Kidney Int. 1992;41:1662-1667.

    Article  PubMed  CAS  Google Scholar 

  16. Shrishrimal K, Hart P, Michota F. Managing diabetes in hemodialysis patients: observations and recommendations. Cleve Clin J Med. 2009;76:649-655.

    Article  Google Scholar 

  17. Ahmed Z, Simon B, Choudhury D. Management of diabetes in patients with chronic kidney disease. Postgrad Med. 2009;121:52-60.

    Article  PubMed  Google Scholar 

  18. Clement S, Braithwaite SS, Magee MF, et al. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004;27:553-591.

    Article  PubMed  Google Scholar 

  19. Van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006;354:449-461.

    Article  PubMed  Google Scholar 

  20. Brunkhorst FM, Engel C, Bloos F, et al. Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med. 2008;358:125-139.

    Article  PubMed  CAS  Google Scholar 

  21. Dube L, Granry JC. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: a review. Can J Anaesth. 2003;50:732-746.

    Article  PubMed  Google Scholar 

  22. Nanji AA. Drug-induced electrolyte disorders. Drug Intell Clin Pharm. 1983;17:175-185.

    PubMed  CAS  Google Scholar 

  23. Dacey MJ. Hypomagnesemic disorders. Crit Care Clin. 2001;17:155-173.

    Article  PubMed  CAS  Google Scholar 

  24. Stoff JS. Phosphate homeostasis and hypophosphatemia. Am J Med. 1982;72:489-495.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Mitchell S. Buckley .

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Buckley, M.S. (2011). Hypertonic Saline, Electrolytes, and Insulin. In: Kane-Gill, S., Dasta, J. (eds) High-Risk IV Medications in Special Patient Populations. Springer, London. https://doi.org/10.1007/978-0-85729-606-1_5

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  • DOI: https://doi.org/10.1007/978-0-85729-606-1_5

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