IVF's for head injuries

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Specializes in ICU/CCU, CVICU, Trauma.

What IV fluids do you use on your patients with head injuries? Why those particular fluids? Over the past 30 years I always used 0.9%NSS, never dextrose. The other day one of our trauma attendings said it doesn't matter. What about hyperglycemia hurting the head? And the whole thing about hypotonic solutions being drawn into the cells, thus increasing ICP? Thanks in advance. :) :thankya:

Ann

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Specializes in ICU.
Conclusions: Treatment of severe head injury with hypertonic saline is superior to that treatment with lactated Ringer's solution. An increase in serum sodium concentrations significantly correlates with lower ICP and higher CPP. Children treated with hypertonic saline require fewer interventions, have fewer complications, and stay a shorter time in the ICU. (Crit Care Med 1998; 26: 1265-1270)

http://www.ccmjournal.com/pt/re/ccm/abstract.00003246-199807000-00032.htm;jsessionid=GcQQZ2dGvLZbcGdrcgSh2JTQGthk811HvGSsLQHppxWtVhLZ4vXh!-1082563917!-949856145!8091!-1

http://www.jtrauma.com/pt/re/jtrauma/abstract.00005373-199801000-00004.htm;jsessionid=GcSJH1Qh38sM3r1cKJD67Qs2Xpqsns8PCC9dTC01vMwGMy1CN5WR!1802132776!-949856144!8091!-1

http://www.ccmjournal.com/pt/re/ccm/abstract.00003246-200004000-00038.htm;jsessionid=GcTDVS5n0299mj1ytqyLt7BzJcmYzQyDVHK9nJgRTpyQ9d2GGTvN!1802132776!-949856144!8091!-1

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Specializes in Trauma/SICU.

we never give d5 to a head trauma...our surgery team tried to do this, and if they won't change their order, i always call the neurosurgeon and tell them and they have my write an order that all ivf's have to be ok'd per neuro. our trauma surgeons don't manage the neuro part of a bad head trauma, they always consult neurosurgery. hope this helps.

jenny

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Specializes in ICU/CCU, CVICU, Trauma.

:thankya: :thankya: :thankya: Thank you!!!!!!!!!!!!!!!!!!!

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