Administering Hypertonic Saline to Patients With Severe Traumatic Brain Injury

Diane Schretzman Mortimer; Jon Jancik


J Neurosci Nurs. 2006;38(3):142-146. 

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Discontinuing HTS Therapy

HTS is continued until patients are no longer considered to be at risk for hyponatremia. The timing varies among patients, but, in general, the risk for hyponatremia persists throughout the subacute period. When the decision is made to discontinue HTS therapy, the drip can be weaned off. The drip rate, regardless of NaCl concentration in the HTS fluid, can be halved every 6 hr. When the rate is 20 ml per hr or less, the drip can be discontinued. During the weaning, serum sodium levels should be checked every 12 hr. If levels increase or decrease unexpectedly, they can be checked more often and addressed appropriately. Management depends on the patient's fluid and electrolyte status and overall clinical condition. After HTS therapy has been discontinued, serum sodium levels do not need to be monitored frequently (Qureshi et al., 1998).


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