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23% hypertonic saline

Mark Elkins, Ruth Dentice
BACKGROUND: Inhalation of hypertonic saline improves sputum rheology, accelerates mucociliary clearance and improves clinical outcomes of people with cystic fibrosis. OBJECTIVES: To determine whether the timing of hypertonic saline inhalation (in relation to airway clearance techniques or in relation to time of day) has an impact on its clinical efficacy in people with cystic fibrosis. SEARCH METHODS: We identified relevant randomised and quasi-randomised controlled trials from the Cochrane Cystic Fibrosis Trials Register, the Physiotherapy Evidence Database (PEDro), and international cystic fibrosis conference proceedings...
December 22, 2016: Cochrane Database of Systematic Reviews
Theresa Human, Aaron M Cook, Brian Anger, Kathleen Bledsoe, Amber Castle, David Deen, Haley Gibbs, Christine Lesch, Norah Liang, Karen McAllen, Christopher Morrison, Dennis Parker, A Shaun Rowe, Denise Rhoney, Kiranpal Sangha, Elena Santayana, Scott Taylor, Eljim Tesoro, Gretchen Brophy
BACKGROUND: Little data exist regarding the practice of sodium management in acute neurologically injured patients. This study describes the practice variations, thresholds for treatment, and effectiveness of treatment in this population. METHODS: This retrospective, multicenter, observational study identified 400 ICU patients, from 17 centers, admitted for ≥48 h with subarachnoid hemorrhage (SAH), traumatic brain injury (TBI), intraparenchymal hemorrhage, or intracranial tumors between January 1, 2011 and July 31, 2012...
January 4, 2017: Neurocritical Care
Sudheer Ambekar, Venkatesh Madhugiri, Paritosh Pandey, Dileep R Yavagal
BACKGROUND: The management of intracranial aneurysms (IAs) varies widely depending upon a number of factors. OBJECTIVE: To understand the variations in practice patterns in the treatment of IAs in India. METHODS: The survey consisted of 23 questions. Two group emails were sent to members of the Neurological Society of India and the Neurological Surgeons Society of India. Uni- and multivariate analysis was performed where appropriate. RESULTS: The response rate was 10...
March 2016: Neurology India
Ruth L Dentice, Mark R Elkins, Peter G Middleton, Jennifer R Bishop, Peter A B Wark, Douglas J Dorahy, Christopher J Harmer, Honghua Hu, Peter T P Bye
BACKGROUND: The mucoactive effects of hypertonic saline should promote exacerbation resolution in people with cystic fibrosis (CF). OBJECTIVES: To determine the effects of hypertonic saline inhalation during hospitalisation for exacerbation of CF on length of stay, lung function, symptoms, oxygenation, exercise tolerance, quality of life, bacterial load and time to next hospitalisation. METHODS: 132 adults with an exacerbation of CF were randomised to inhale three nebulised doses a day of either 4 mL 7% saline or a taste-masked control of 0...
February 2016: Thorax
Anja Jochmann, Luca Artusio, Karen Robson, Prasad Nagakumar, Nicola Collins, Louise Fleming, Andrew Bush, Sejal Saglani
BACKGROUND: We hypothesized airway inflammation can be detected non-invasively by induced sputum (IS) or peripheral blood eosinophilia, and IS can detect bacterial and viral infection in preschool children with airway disease, with results comparable to broncho-alveolar lavage (BAL). METHODS: Preschool children with cystic fibrosis, recurrent wheeze, or wet cough underwent IS with nebulized hypertonic saline, chest physiotherapy, and oropharyngeal suction. Samples were analyzed for inflammation by cytology and bacterial culture, viral detection by PCR...
August 2016: Pediatric Pulmonology
Aayush Khanal, Arun Sharma, Srijana Basnet, Pushpa Raj Sharma, Fakir Chandra Gami
BACKGROUND: To Assess the efficacy of nebulised hypertonic saline (HS) (3%) among children with mild to moderately severe bronchiolitis. METHODS: Infants aged 6 weeks to 24 months, with a first episode of wheezing and Clinical Severity scores (Arch Dis Child 67:289-93, 1992) between 1 and 8, were enrolled over 4 months duration. Those with severe disease, co-morbidities, prior wheezing, recent bronchodilator and steroid use were excluded. Patients were randomized in a double-blind fashion, to receive two doses of nebulized 3% HS (Group 1) or 0...
September 10, 2015: BMC Pediatrics
A M Youssef, V G Macefield, L A Henderson
Conditioned pain modulation is a powerful analgesic mechanism, occurring when a painful stimulus is inhibited by a second painful stimulus delivered at a different body location. Reduced conditioned pain modulation capacity is associated with the development of some chronic pain conditions and the effectiveness of some analgesic medications. Human lesion studies show that the circuitry responsible for conditioned pain modulation lies within the caudal brainstem, although the precise nuclei in humans remain unknown...
January 1, 2016: NeuroImage
Eric M Liotta, Bryan D Lizza, Anna L Romanova, James C Guth, Michael D Berman, Timothy J Carroll, Brandon Francis, Daniel Ganger, Daniela P Ladner, Matthew B Maas, Andrew M Naidech
OBJECTIVE: Cerebral edema is common in severe hepatic encephalopathy and may be life threatening. Bolus 23.4% hypertonic saline improves surveillance neuromonitoring scores, although its mechanism of action is not clearly established. We investigated the hypothesis that bolus hypertonic saline decreases cerebral edema in severe hepatic encephalopathy utilizing a quantitative technique to measure brain and cerebrospinal fluid volume changes. DESIGN: Retrospective analysis of serial CT scans, and clinical data for a case-control series were performed...
January 2016: Critical Care Medicine
Mark L Everard, Daniel Hind, Kelechi Ugonna, Jennifer Freeman, Mike Bradburn, Simon Dixon, Chin Maguire, Hannah Cantrill, John Alexander, Warren Lenney, Paul McNamara, Heather Elphick, Philip Aj Chetcuti, Eduardo F Moya, Colin Powell, Jonathan P Garside, Lavleen Kumar Chadha, Matthew Kurian, Ravinderjit S Lehal, Peter I MacFarlane, Cindy L Cooper, Elizabeth Cross
BACKGROUND: Acute bronchiolitis is the most common cause of hospitalisation in infancy. Supportive care and oxygen are the cornerstones of management. A Cochrane review concluded that the use of nebulised 3% hypertonic saline (HS) may significantly reduce the duration of hospitalisation. OBJECTIVE: To test the hypothesis that HS reduces the time to when infants were assessed as being fit for discharge, defined as in air with saturations of > 92% for 6 hours, by 25%...
August 2015: Health Technology Assessment: HTA
Janni M Jensen, Frank H Mose, Anna-Ewa O Kulik, Jesper N Bech, Robert A Fenton, Erling B Pedersen
AIM: To quantify changes in urinary excretion of aquaporin2 water channels (u-AQP2), the sodium-potassium-chloride co-transporter (u-NKCC2) and the epithelial sodium channels (u-ENaC) during treatment with bendroflumethiazide (BFTZ), amiloride and placebo. METHODS: In a randomized, double-blinded, placebo-controlled, 3-way crossover study we examined 23 healthy subjects on a standardized diet and fluid intake. The subjects were treated with amiloride 5 mg, BFTZ 1...
July 6, 2015: World Journal of Nephrology
David Rabago, Marlon Mundt, Aleksandra Zgierska, Jessica Grettie
OBJECTIVE: Knee osteoarthritis (OA) is a common, debilitating chronic disease. Prolotherapy is an injection therapy for chronic musculoskeletal pain. Recent 52-week randomized controlled and open label studies have reported improvement of knee OA-specific outcomes compared to baseline status, and blinded saline control injections and at-home exercise therapy (p<0.05). However, long term effects of prolotherapy for knee OA are unknown. We therefore assessed long-term effects of prolotherapy on knee pain, function and stiffness among adults with knee OA...
June 2015: Complementary Therapies in Medicine
Wei Li, Jun Xu, Dingyu Tan, Xuezhong Yu
OBJECTIVE: To evaluate the efficacy of hypertonic saline (HS) treatment in cardiopulmonary resuscitation (CPR) in animal models of cardiac arrest (CA). METHODS: PubMed and EMBASE data were retrieved from January 1st, 1966 to September 30th, 2014, and Wanfang data and CNKI were searched from January 1st, 1990 to September 30th, 2014 for randomized controlled trials (RCTs) regarding CPR intervention of CA animal models with HS. HS was intravenously infused at the initiation of CPR in HS group, without limiting its dosage or concentration...
March 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
B J Piper, P W Harrigan
We describe the protocolised use of 23.4% hypertonic saline solution (HTS) for intracranial hypertension in the context of traumatic brain injury in the paediatric population. This study represents the largest published data on the use of 23.4% HTS in the paediatric population. In this retrospective cohort, we focus on the efficacy, biochemical and metabolic consequences of 23.4% HTS administration in a Level 1 paediatric trauma centre. Mortality in the first seven days was 6% (2/32) with a mean intensive care unit length-of-stay of ten days (range 2 to 25, standard deviation [SD] 6)...
March 2015: Anaesthesia and Intensive Care
F M Trefz, A Lorch, J Zitzl, A Kutschke, G Knubben-Schweizer, I Lorenz
BACKGROUND: Increased plasma potassium concentrations (K(+)) in neonatal calves with diarrhea are associated with acidemia and severe clinical dehydration and are therefore usually corrected by intravenous administration of fluids containing sodium bicarbonate. OBJECTIVES: To identify clinical and laboratory variables that are associated with changes of plasma K(+) during the course of treatment and to document the plasma potassium-lowering effect of hypertonic (8...
March 2015: Journal of Veterinary Internal Medicine
A R Ojha, S Mathema, S Sah, U R Aryal
BACKGROUND: Bronchiolitis is a common clinical problem in children below 2 years presenting with respiratory symptoms. As there is necrosis and sloughing of epithelial cells, edema, increased secretion of mucus causing obstruction of large and small airways we aim to see the clinical profile and the effect of use of hypertonic (3%) saline nebulization in these children. METHODS: A double blind randomized controlled trial was conducted at department of Pediatrics, in a hospital from July 2012 to August 2013...
January 2014: Journal of Nepal Health Research Council
Yi Yang, Wei Guo, Rongli Yang, Xiaodong Tang, Taiqiang Yan, Tao Ji, Ran Wei
OBJECTIVE: To analyze the clinical outcome of an operative technique using recycling bones to reconstruct pelvis after primary malignant pelvic tumor resection. METHODS: Fifteen patients who presented with malignant pelvic tumors were treated by wide or marginal resection and reconstruction using recycling bone in our institute from January 2003 to December 2011. The median age was 31 (15-62) years, and the most common diagnosis was chondrosarcoma, followed by Ewing sarcoma...
October 2014: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Mark L Everard, Daniel Hind, Kelechi Ugonna, Jennifer Freeman, Mike Bradburn, Cindy L Cooper, Elizabeth Cross, Chin Maguire, Hannah Cantrill, John Alexander, Paul S McNamara
AIM: Acute bronchiolitis is the commonest cause for hospitalisation in infancy. Supportive care remains the cornerstone of current management and no other therapy has been shown to influence the course of the disease. It has been suggested that adding nebulised hypertonic saline to usual care may shorten the duration of hospitalisation. To determine whether hypertonic saline does have beneficial effects we undertook an open, multi-centre parallel-group, pragmatic RCT in ten UK hospitals...
December 2014: Thorax
Halinder S Mangat, Ya-Lin Chiu, Linda M Gerber, Marjan Alimi, Jamshid Ghajar, Roger Härtl
OBJECT: Increased intracranial pressure (ICP) in patients with traumatic brain injury (TBI) is associated with a higher mortality rate and poor outcome. Mannitol and hypertonic saline (HTS) have both been used to treat high ICP, but it is unclear which one is more effective. Here, the authors compare the effect of mannitol versus HTS on lowering the cumulative and daily ICP burdens after severe TBI. METHODS: The Brain Trauma Foundation TBI-trac New York State database was used for this retrospective study...
January 2015: Journal of Neurosurgery
Paul Nolan, Hari Gourabathini, Chau Tran, Saloni Paudel, Elena Romero
Pediatric Medicine PostersSESSION TYPE: Original Investigation PosterPRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PMPURPOSE: There are no published guidelines, clinical trials or case series in the management of recalcitrant atelectasis in the infants and toddlers with high frequency chest wall oscillation (HFCWO).METHODS: A retrospective case series of the clinical experience in the management of atelectasis with HFCWO in post term infants and toddlers was conducted at Driscoll Children's Hospital including noncardiac, cardiac, non PICU and PICU patients from December 2010 to March 2014...
October 1, 2014: Chest
Robin Guo, Marc Montecillo, Nader Kamangar
Critical Care Student/Resident Case Report Posters IIISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Transurethral resection of the prostate (TURP) syndrome is a rare condition classically characterized by hyponatremia, altered mental status, and hypervolemia caused by large volume bladder irrigation with hypotonic glycine or cytal solution during TURP. Ionic solutions are not traditionally used because they dissipate the cutting power of monopolar instruments...
October 1, 2014: Chest
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