Administration of hypertonic (3%) sodium chloride/acetate in hyponatremic patients with symptomatic vasospasm following subarachnoid hemorrhage

J. I. Suarez, A. I. Qureshi, P. D. Parekh, A. Razumovsky, R. J. Tamargo, Anish Bhardwaj, J. A. Ulatowski

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

A retrospective study was carried out to evaluate the effect of hypertonic (3%) saline chloride/acetate on various hemodynamic parameters in mildly hyponatremic patients with symptomatic vasospasm following aneurysmal subarachnoid hemorrhage (SAH). We identified 29 hyponatremic (serum sodium < 135 mEq/L) patients who received hypertonic (3%) sodium chloride/acetate as a continuous infusion. Administration of hypertonic (3%) sodium chloride/acetate resulted in higher central venous pressures and positive fluid balance, with a concomitant increase in serum sodium and chloride concentrations without metabolic acidosis. There were no changes in mean cerebral blood flow velocities after infusion of hypertonic (3%) sodium chloride/acetate. We found no reports of congestive heart failure, pulmonary edema, metabolic acidosis, coagulopathy, intracranial hemorrhages, or central pontine myelinolysis in any of these patients. We conclude that hypertonic (3%) sodium chloride/acetate can be administered to patients with mild hyponatremia in the setting of symptomatic vasospasm following SAH without untoward effects. Sample size and limitations of a retrospective analysis preclude conclusions about safety and efficacy of hypertonic (3%) sodium chloride/acetate administration in this patient population. However, our results support justification for a prospective, randomized, double-blind trial of hypertonic (3%) sodium chloride/acetate versus normal saline in patients with symptomatic vasospasm following SAH.

Original languageEnglish (US)
Pages (from-to)178-184
Number of pages7
JournalJournal of Neurosurgical Anesthesiology
Volume11
Issue number3
StatePublished - Jul 1999
Externally publishedYes

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Sodium Acetate
Subarachnoid Hemorrhage
Sodium Chloride
Acidosis
Cerebrovascular Circulation
Central Pontine Myelinolysis
Central Venous Pressure
Water-Electrolyte Balance
Blood Flow Velocity
Hyponatremia
Intracranial Hemorrhages
Pulmonary Edema
Serum
Sample Size
Chlorides
Acetates
Heart Failure
Retrospective Studies
Hemodynamics
Sodium

Keywords

  • Cerebral
  • Hypertonic
  • Saline
  • Subarachnoid
  • Vasospasm

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

Cite this

Administration of hypertonic (3%) sodium chloride/acetate in hyponatremic patients with symptomatic vasospasm following subarachnoid hemorrhage. / Suarez, J. I.; Qureshi, A. I.; Parekh, P. D.; Razumovsky, A.; Tamargo, R. J.; Bhardwaj, Anish; Ulatowski, J. A.

In: Journal of Neurosurgical Anesthesiology, Vol. 11, No. 3, 07.1999, p. 178-184.

Research output: Contribution to journalArticle

Suarez, J. I. ; Qureshi, A. I. ; Parekh, P. D. ; Razumovsky, A. ; Tamargo, R. J. ; Bhardwaj, Anish ; Ulatowski, J. A. / Administration of hypertonic (3%) sodium chloride/acetate in hyponatremic patients with symptomatic vasospasm following subarachnoid hemorrhage. In: Journal of Neurosurgical Anesthesiology. 1999 ; Vol. 11, No. 3. pp. 178-184.
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