SODIUM CHLORIDE 3%
(Hypertonic Saline 3%, Mucoclear 3%)Standard Prescription
Inhalation:
hypertonic saline 3% ____mL by inhalation Q__H
Intravenous:
hypertonic saline 3% ____ml/kg IV over ___ mins
hypertonic saline 3% ____mL by inhalation Q__H
Intravenous:
hypertonic saline 3% ____ml/kg IV over ___ mins
Dosages
Hyponatremia
Serum sodium <125 mmol/L and no symptoms:
1. Sodium (mmol) required to correct to target of 125 mmol/L = 0.6 x weight (kg) x (125 - current serum sodium).
2. Volume of sodium chloride 3% needed (mL) = sodium required (mmol) / 0.513 mmol Na/mL.
3. Administer sodium chloride 3% IV centrally at a maximum rate of 0.5 - 1 mmol/kg/hour (1 - 2 mL/kg/hour)
or 100 mL/hour.
Emergency correction of sodium when patient having symptoms (eg. seizures):
Administer the calculated dose, up to a maximum of 6 mL/kg, IV over a period of 60 minutes.
Critical Care Protocol for the Management of Severe Head Injuries:
1 - 2.5 mmol/kg/dose (2 - 5 mL/kg/dose) IV over 10 minutes. May repeat PRN.
Aim to maintain serum sodium less than 160 mmol/L.
Bronchiolitis:
4 mL inhaled via nebulizer Q8H.
Serum sodium <125 mmol/L and no symptoms:
1. Sodium (mmol) required to correct to target of 125 mmol/L = 0.6 x weight (kg) x (125 - current serum sodium).
2. Volume of sodium chloride 3% needed (mL) = sodium required (mmol) / 0.513 mmol Na/mL.
3. Administer sodium chloride 3% IV centrally at a maximum rate of 0.5 - 1 mmol/kg/hour (1 - 2 mL/kg/hour)
or 100 mL/hour.
Emergency correction of sodium when patient having symptoms (eg. seizures):
Administer the calculated dose, up to a maximum of 6 mL/kg, IV over a period of 60 minutes.
Critical Care Protocol for the Management of Severe Head Injuries:
1 - 2.5 mmol/kg/dose (2 - 5 mL/kg/dose) IV over 10 minutes. May repeat PRN.
Aim to maintain serum sodium less than 160 mmol/L.
Bronchiolitis:
4 mL inhaled via nebulizer Q8H.
Mechanism of Action
Sodium Chloride replacement, Hypertonic solution
Forms Supplied
ampoule for inhalation: 3% Sodium Chloride in 4 mL ampoule
injection: 3% sodium chloride (0.513 mmol/mL) (250 mL)
injection: 3% sodium chloride (0.513 mmol/mL) (250 mL)
Comments
If serum sodium is less than 140 mmol/L, 3% NaCl should be used for management of increased ICP. If serum sodium is greater than 140 mmol/L, 3% NaCl or mannitol could be considered for management.
Evidence suggest 3% NaCl may be the preferred treatment for increased ICP due to multisystem trauma and cerebral edema from DKA.
3% sodium chloride 5 mL/kg is the equivalent dose of 20% mannitol 1 gram/kg.
Nebulized hypertonic saline no longer recommended for bronchiolitis as studies have shown it is ineffective.
Bronchospasm is a rare adverse effect of hypertonic saline when used for bronchiolitis.
Do not use injection for nebulization.
Evidence suggest 3% NaCl may be the preferred treatment for increased ICP due to multisystem trauma and cerebral edema from DKA.
3% sodium chloride 5 mL/kg is the equivalent dose of 20% mannitol 1 gram/kg.
Nebulized hypertonic saline no longer recommended for bronchiolitis as studies have shown it is ineffective.
Bronchospasm is a rare adverse effect of hypertonic saline when used for bronchiolitis.
Do not use injection for nebulization.
References
341, 342, 343, 344, 345, 346, 347, 348, 542, 543, 544
Last Edited
2022-09-11 00:39:42