Available online 9 February 2013
Publication year: 2013
Source:World Neurosurgery
Objective To review and summarize controversies and current concepts regarding the use of hypertonic saline during perioperative period in Neurosurgery. Methods Relevant literature was searched on Pubmed and Scopus electronic database to identify all studies that have investigated the use of hypertonic saline in Neurosurgery. Results Fluid management during the course of neurosurgical practice has been debated at length, especially strategies to control intracranial pressure and small volume resuscitation. The goal of fluid therapy includes minimizing cerebral edema, preserving intravascular volume, and maintaining cerebral perfusion pressure. Mannitol is widely recognized as the 'gold-standard' for treating intracranial hypertension but can result in systemic hypotension. Thus, hypertonic saline provides volume expansion and may improve cerebral and systemic hemodynamics. However, recently published prospective data regarding the use of osmotic agents fails to establish clear guidelines in neurosurgical patients. Conclusion We suggest hypertonic saline will emerge as an alternative to mannitol, especially for a long term use or multiple doses are needed and lead to a great opportunity for collaborative research.
Júlio Leonardo B. Pereira
Phone: (+1) 424-2301706
Linkedin:http://www.linkedin.com/in/juliommais
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