Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/32347
Title: Early and prolonged continuous hypertonic saline infusion in patients with acute liver failure.
Austin Authors: Michel, Claire;Warming, Scott;Neto, Ary Serpa;Abeygunawardana, Vihangi;Fisher, Caleb ;Kishore, Kartik ;Warrillow, Stephen J ;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia.
Intensive Care
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia; Data Analytics Research and Evaluation Centre, Austin Hospital, Melbourne, Australia.
Data Analytics Research and Evaluation (DARE) Centre
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia; Department of Intensive Care, Austin Hospital, Melbourne, Australia.
Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Australia; Department of Intensive Care, Austin Hospital, Melbourne, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia; Data Analytics Research and Evaluation Centre, Austin Hospital, Melbourne, Australia; Department of Critical Care, University of Melbourne, Melbourne, Australia.
Issue Date: Aug-2023
Date: 2023
Publication information: Journal of Critical Care 2023-08; 76
Abstract: To study patient characteristics, physiological changes, and outcomes associated with prolonged continuous hypertonic saline (HTS) infusion in acute liver failure (ALF). Retrospective observational cohort study of adult patients with ALF. We collected clinical, biochemical, and physiological data six hourly for the first week, daily until day 30 or hospital discharge, and weekly, when documented, until day 180. Of 127 patients, 85 received continuous HTS. Compared with non-HTS patients they were more likely to receive continuous renal replacement therapy (CRRT) (p < 0.001) and mechanical ventilation (p < 0.001). Median HTS duration was 150 (Interquartile range (IQR): 84-168) hours, delivering a median 2244 (IQR: 979-4610) mmol sodium load. Median peak sodium concentration was 149 mmol/L vs 138 mmol/L in non-HTS patients (p < 0.001). The median rate of sodium increase with infusion was 0.1 mmol/L/h and median rate of decrease during weaning was 0.1 mmol/L every 6 h. Median lowest pH value was 7.29 vs. 7.35 in non-HTS patients. Survival of HTS patients was 72.9% overall and 72.2% without transplantation. In ALF patients, the prolonged administration of HTS infusion was not associated with severe hypernatremia or rapid shifts in serum sodium upon commencement, delivery, or weaning.
URI: https://ahro.austin.org.au/austinjspui/handle/1/32347
DOI: 10.1016/j.jcrc.2023.154289
ORCID: 
Journal: Journal of Critical Care
Start page: 154289
PubMed URL: 36933387
ISSN: 1557-8615
Type: Journal Article
Subjects: Acute liver failure
Cerebral edema
Chloride
Critical care
Hypernatremia
Hypertonic saline
Sodium
Appears in Collections:Journal articles

Show full item record

Page view(s)

102
checked on Jun 26, 2024

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.