Hypertonic SalineDose, contraindications and adverse effects for Cats, Cattle, Dogs, Horses and Poultry.

Concentrated sodium chloride solution; used in small volumes for rapid, temporary vascular volume expansion in shock. Hypertonic saline (HTS) solutions with concentrations of 7% to 7.5% are most commonly used in veterinary medicine. HTS is used as an alternative to isotonic crystalloids for resuscitation in previously normovolemic healthy patients with intravascular hypovolemic shock, and in patients with burns or hypovolemic traumatic brain injury (TBI). HTS is particularly useful in conditions where large f

Small bolus doses of hypertonic saline (HTS) can cause immediate intravascular volume expansion. High sodium concentration increases plasma osmolarity, causing movement of water from the interstitial space into the intravascular space. Intravascular volume expansion can be in excess of the amount of HTS infused.

Hypertonic saline (HTS) is contraindicated in patients with significant hypernatremia, hyperosmolality, hyperchloremia, hypokalemia, or intravascular overload. It must be used with extreme caution in dehydrated patients, and isotonic crystalloid therapy is required after HTS infusion to replenish interstitial and intracellular water. Adequate patient monitoring is mandatory as the effects of HTS are transient and critically ill patients can rapidly decompensate.

When used at dosages less than 5 mL/kg IV and at infusion rates not greater than 1 mL/kg/minute IV, hypertonic saline (HTS) is considered relatively safe in patients where it is not contraindicated. If infused at a higher rate (infusion time less than 1 minute, or infusion rate greater than 1 mL/kg/minute), arteriolar vasodilation with transient reductions in mean arterial pressure and vagally mediated bradycardia can occur.

■ Efficacy: blood pressure, central venous pressure (if possible), and clinical parameters (eg, heart rate, pulse quality, mucous membrane color, capillary refill time, mental acuity, body temperature) ■ Serum electrolytes (ie, sodium, potassium, chloride), serum osmolality, urine output, hematocrit