Is the Use of Hypertonic Saline Effective in Reducing Intracranial Pressure After Traumatic Brain Injury in Dogs?

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Appraisal, application and reflection

The purpose of this Knowledge Summary was to look at the evidence for the use of hypertonic saline in reducing intracranial pressure in head trauma patients.

The experimental studies available in dogs seem to indicate that hypertonic saline might have a good effect on increased intracranial pressure after traumatic brain injury while achieving desirable haemodynamic parameters.

There are no controlled clinical studies that evaluate the use of hypertonic saline as an independent variable. In the descriptive study from Sharma & Holowaychuck (2015) the decision to use hypertonic saline was the clinician’s, and sometimes made after other treatment options had been unsuccessful. The choice to use hypertonic saline appears mostly to have been made in very severe cases, which may explain the negative predictive value of hypertonic saline use on survival until discharge.

In conclusion, hypertonic saline appears to be effective in reducing intracranial pressure after traumatic brain injury in experimental studies. How effective its use might be in clinical settings cannot be answered.

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