Johnson Andrea L, Criddle Laura M
trauma/neuro intensive care unit at Oregon Health & Science University, Portland, Ore, USA.
Crit Care Nurse. 2004 Oct;24(5):36-8, 40-4, 46 passim.
Sodium is the most abundant extracellular ion. Historically, therapy with hypertonic saline was widely used for a variety of conditions. Currently, there are 3 primary indications for its use in critical care: hyponatremia, volume resuscitation, and brain injury. SIADH and CSW syndrome may require sodium replacement, but most cases of hyponatremia can be managed without administration of hypertonic saline. Studies of use of hypertonic saline in hypovolemia and brain injury are promising, but additional research is needed to better define optimal dosing regimens and to determine the relative risks associated with hypertonic saline versus conventional treatment for the management of patients with head injuries and for volume resuscitation in shock states.
钠是细胞外最丰富的离子。从历史上看，高渗盐水疗法曾广泛用于多种病症。目前，其在重症监护中的主要应用指征有3个：低钠血症、容量复苏和脑损伤。抗利尿激素分泌异常综合征和脑性盐耗综合征可能需要补充钠，但大多数低钠血症病例无需使用高渗盐水即可处理。高渗盐水用于低血容量和脑损伤的研究前景良好，但需要更多研究来更好地确定最佳给药方案，并确定与高渗盐水相比，传统治疗在颅脑损伤患者管理和休克状态下容量复苏方面的相对风险。
