Red blood cells are normally very buoyant in the body. However, when they become hypertonic, they lose part or all of their volume and become less dense.
Hypertonic solutions are used to treat shock, stroke, and heart failure. They help to increase blood volume and improve perfusion to tissues and organs.
Hypertonic saline is made up of a saline solution that contains a high concentration of dextrose. It can be administered intravenously.
Dextrose is a simple sugar that makes up about 2 percent of the final solution.
What are the side effects of hypertonic saline?
All hypertonic solutions carry some risk of adverse effects. However, for most people with severe sepsis, the risk is low and the benefits of treatment are high.
The possible side effects of hypertonic saline include:
- Allergic reaction
- Allergic reaction to dextrose
- Decreased blood clotting
- Decreased organ function
- Electrolyte imbalance
- Kidney damage
- Renal failure
Hypertonic saline is not recommended for:
- People with a history of seizures
- People who plan to have surgery
- People who have a brain tumor
- People with a history of a severe allergic reaction to dextrose
- People with very low blood pressure
How do you administer hypertonic saline?
Hypertonic saline is given intravenously (through a vein). It is usually administered over a period of several hours.
Hypertonic saline is administered through a syringe that has a tube that goes into your vein and into a bag of saline. This is called a central line. It is usually inserted into a vein in your hand or arm.
Once the saline has been administered, the needle is removed. The line and bag of saline will be flushed out with sterile water.
You may feel a warm, prickling sensation when the needle is inserted into your vein. You may also experience a slight headache, dizziness, or nausea.
You will be monitored for complications, such as high blood pressure or low blood pressure.
What do the results show?
Hypertonic saline improves blood volume and circulation. It also helps to restore tissue perfusion.
Hypertonic saline has been shown to quickly improve blood pressure in people with septic shock.
It also appears to reverse some of the effects of sepsis, such as organ failure.
It is not known how hypertonic saline may affect long-term outcomes.
What are the risks?
The risks associated with hypertonic saline include:
- Allergic reaction. Some people may experience an allergic reaction to the saline when it is administered intravenously.
- Allergic reaction to dextrose. Some people may experience an allergic reaction to dextrose if it is used to make the hypertonic saline solution.
- Hypotension. Hypertonic saline may cause slow blood pressure changes. This can lead to hypotension, which is a low blood pressure.
- Renal failure. Hypertonic saline can cause kidney damage. This can lead to kidney failure.
- Electrolyte imbalance. Hypertonic saline can cause electrolyte imbalances.
- Kidney damage. Hypertonic saline can cause kidney damage.
In people with severe sepsis, the risk of these side effects is low.
People who are taking other medications for sepsis and who are also taking hypertonic saline may be at risk of an electrolyte imbalance.
What preparations of hypertonic saline do you give?
Hypertonic saline contains dextrose. It is usually prepared as a solution that contains 2.5 grams of dextrose per liter of saline.
Other preparations may contain less dextrose. It is not known how much dextrose is in hypertonic saline.
Some people do not need to take any preparation of hypertonic saline.
How do you give hypertonic saline?
Hypertonic saline can be given intravenously:
- In the hospital: Hypertonic saline may be given intravenously in the hospital. In this case, it may be given into a vein in your hand or arm. This is called central line placement.
- At home: Hypertonic saline can be given intravenously at home. You may be able to do this at home.
Hypertonic saline can also be given in a drip:
- In the hospital: Hypertonic saline can be given into a drip in the hospital.
- At home: Hypertonic saline can be given into a drip at home.
Hypertonic saline may be used to replace blood transfusions. It may also be used to replace other types of blood products, such as red blood cells, platelets, or plasma.
You may get a prescription for a hypertonic saline drip. This means that a healthcare provider will give you the treatment.
The prescription may be given directly to you or it may be given to your family members or other health care professionals.
How much hypertonic saline do you need?
Hypertonic saline needs to be given as a continuous infusion. You will need to use it for a long time, often for several hours.
Before you give hypertonic saline to someone, you should always do a health history and risk assessment. This will help you to understand:
- What the person will be expected to do
- What the risks are
- What the side effects are
You should also do a physical examination, which will help you to understand how much the person weighs and how much fluid is in their body.
What should you avoid while giving hypertonic saline?
Any medications or supplements you are taking should be stopped before giving hypertonic saline.
Some people may be allergic to the dextrose in hypertonic saline. You should not use hypertonic saline if there is a possibility you may be allergic to dextrose.
What are the dosages for hypertonic saline?
The dosage of hypertonic saline depends on the person.
In people with septic shock, hypertonic saline should be given as a continuous drip. The drip will be given for about 6 to 8 hours. The total amount of hypertonic saline will be about 8 to 10 liters.
In people with normal blood pressure, the average dose is 100 to 120 milliliters per hour.
For people with heart failure, the dosage may be less.
The dosage may also depend on the size of the person.
How does it work?
Hypertonic saline works by drawing water into the blood and replacing it with isotonic saline solution.
Isotonic means the same as normal saline. The extra water in hypertonic saline dilutes the blood, causing it to become more concentrated in salt.
A large amount of water in the blood will lower blood pressure and the person’s blood volume. This can make it easier for the person to breathe. It can also help them feel better.
Hypertonic saline can also reduce the risk of organ failure.
Hypertonic solutions are solutions that are too concentrated for your blood. They’re commonly used in emergency situations.
Hypertonic solutions are used to increase the strength of blood. Hypertonic solutions can cause serious complications if they aren’t diluted properly.
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