SciELO - Scientific Electronic Library Online

vol.79 suppl.2Inhaled nitric oxide in pediatricsAdvances in sepsis diagnosis and treatment author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Jornal de Pediatria

Print version ISSN 0021-7557On-line version ISSN 1678-4782


CARVALHO, Werther Brunow de. Hypertonic solutions for pediatric patients. J. Pediatr. (Rio J.) [online]. 2003, vol.79, suppl.2, pp.S187-S194. ISSN 0021-7557.

OBJECTIVE: To describe the current knowledge and indications for use of hypertonic saline solutions in pediatrics patients. SOURCE OF DATA: Medline recent review articles and personal files. SUMMARY OF THE FINDINGS: Basic physiologic principles were reviewed concerning the distribution of fluid inside the intravascular, interstitial and intracellular compartments. We also reviewed the findings concerning the mechanisms responsible for the rapid onset of cardiocirculatory effects and the additional effect of the colloid component. Finally, we present the medical terms used in the context of small-volume resuscitation, the indications for clinical use, the evidence from clinical research (hemorrhagic shock, preclinical trauma care, septic shock, and head trauma), and the disadvantages and potential adverse effects of small-volume resuscitation. CONCLUSIONS: Resuscitation by means of hypertonic saline solutions associated or not with colloid solutions is one of the most innovative concepts for primary resuscitation from trauma and shock established in the past decade. Currently, the spectrum of potential indications involves not only prehospital trauma care, but also perioperative and intensive care therapy. However, additional randomized double-blind studies are required with both children and adult patients to confirm the advantages of the method in terms of survival.

Keywords : Hypertonic saline solutions; pediatrics; fluid resuscitation; critical care.

        · abstract in Portuguese     · text in English | Portuguese     · English ( pdf epdf ) | Portuguese ( pdf epdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License