3 per cent ns dose pediatrics
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Finding Sources
Finding Sources
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Now let me also get the Rosen's table snippet that showed the hyponatremia dosing:
Reading File
Here is a concise, evidence-based summary of 3% Normal Saline (hypertonic saline) dosing in pediatrics:
3% NaCl (Hypertonic Saline) — Pediatric Dosing
1. Symptomatic Hyponatremia / Hyponatremic Seizures
| Route | Dose | Rate |
|---|---|---|
| IV bolus | 2–5 mL/kg (up to 150 mL/dose) | Over 20 minutes |
Goal: raise serum sodium by ~5 mEq/L to stop seizure activity; do not correct too rapidly (risk of osmotic demyelination if chronic).
— Rosen's Emergency Medicine, Table 88-4
2. Raised Intracranial Pressure (ICP) / Pediatric TBI
Bolus dosing:
- 2–5 mL/kg IV over 10–20 minutes
- Repeat doses can be given as needed
Continuous infusion:
- 0.1–1.0 mL/kg/h on a sliding scale titrated to ICP response (Level II evidence, Pediatric TBI Guidelines 2019)
Monitoring targets:
- Serum osmolality < 320 mOsm/L
- Sustained serum sodium < 160 mEq/L
— Miller's Anesthesia 10e, p. 11399; Mulholland & Greenfield's Surgery 7e, p. 1453
Key Points
- 3% saline is the preferred hyperosmolar agent in pediatric TBI (Grade II evidence, 2019 guidelines), as sodium does not cross the blood–brain barrier rapidly, creating an osmotic gradient similar to mannitol.
- Additional benefits: enhances cardiac output, reduces inflammation, restores normal cellular resting membrane potential.
- For ICP management, mannitol (0.25–1 g/kg IV bolus) remains an alternative.
- Always monitor serum Na⁺ and osmolality closely.
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