Early and prolonged continuous hypertonic saline infusion in patients with acute liver failure
Authors' conclusion
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.
Study context
- Population
- Adults with acute liver failure (ALF)
- Participants
- 127 adults
- Exposure
- Continuous hypertonic saline (HTS) vs no HTS
- HTSn = 85
- Outcome
- Serum sodium with HTS
Main finding
As reported in the abstract
P < 0.001
- Median HTS duration (IQR 84-168)
- 150 hours
- Median sodium load (IQR 979-4610)
- 2244 mmol
- Median rate of sodium increase with infusion
- 0.1 mmol/L/h
- Median rate of sodium decrease during weaning
- 0.1 mmol/L every 6 h
Observational data: associations, not effects.
Further findings
Median
| Outcome | HTS | non-HTS | P value |
|---|---|---|---|
| CRRT and mechanical ventilationCRRT more likely with HTS | P < 0.001 | ||
| CRRT and mechanical ventilationMechanical ventilation more likely with HTS | P < 0.001 | ||
| Lowest pH | 7.29 | 7.35 |
Survival of HTS patients
- Overall
- 72.9%
- Without transplantation
- 72.2%
Original publication
Early and prolonged continuous hypertonic saline infusion in patients with acute liver failure. J Crit Care. Published 16 March 2023. doi:10.
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