Safety of Administration of Hypertonic Sodium Chloride Solution Through Peripheral IV in Neuroscience Intensive Care Unit, KAMC, Makkah

Abstract

Background: Infusions of 3% sodium chloride are routinely recommended to be given through central venous catheters, not peripheral IV lines. In addition, no data are available on the proper site for administration of a continuous intravenous infusion of 3% sodium chloride solution in adults. Some recent studies have illustrated that this theory may not be relevant, and that 3% sodium chloride may be safe for administration in peripheral IV lines. Aims and Objectives: To evaluate the incidence of infusion-related reactions in neuro intensive care patients treated with continuous intravenous infusion of hypertonic sodium chloride up to 3% solution via peripheral IV catheter. Methods: Data on patients treated with continuous intravenous infusion of hypertonic sodium chloride up to 3% solution through peripheral IV cannula for at least 24 hours at neuroscience intensive care unit were evaluated by using prospective observational design to determine the complications in administration site such as phlebitis, infiltration, extravasation, thrombosis and line infection. Results: Out of 43 patients with peripheral hypertonic saline infusion (up to 3%), no incidence of complications were reported after 24 hours of continuous infusion. Out of 34 patients who continued their infusion to second day, one incidence of phlebitis and 2 incidences of extravasation were reported. 20 patients were on continuous infusion towards day 3, where also one incidence of phlebitis and 2incidencese of extravasation were reported. Overall complications reported in all 97 peripheral hypertonic saline infusion days were 2 incidence of phlebitis and 4incidences of extravasation. Conclusion: Current recommendations that a central catheter is required for continuous intravenous infusion of hypertonic sodium chloride up to 3% should be reconsidered. Only a few patients who had peripheral infusions had infusion-related complications. Peripheral intravenous administration of hypertonic saline can be used safely and effectively in patients without a central line.