Abstract
Hypertonic saline (HTS) is a group of fluids containing sodium and chloride in a higher
concentration as compared to physiological saline. The authors have conducted this
review to evaluate the use of HTS in neuroanesthesia and neurocritical care. The articles
for this narrative review on HTS were searched on databases like PubMed Central, EMBASE,
and Google Scholar using the Medical Subject Headings keywords “Hypertonic Saline,”
“Neuroanesthesia,” and “Neurocritical Care.” The review focuses on the mechanisms
of HTS and its in routine clinical practice. The results of various comparative studies
between HTS and mannitol and guidelines regarding the use of HTS have also been reviewed.
HTS can be used to treat hyponatremia, reduce intracranial pressure, provide intraoperative
relaxed brain, and aid in resuscitation during cardiogenic, neurogenic, and septic
shock. Its side effects include renal toxicity in the case of hypernatremia, rebound
intracranial hypertension, volume overload, dyselectrolytemia, phlebitis, local tissue
damage, and osmotic demyelination syndrome in the case of rapid correction of serum
sodium concentration.
Keywords
hypertonic saline - neuroanesthesia - neurocritical care
