hypertonic saline in burns resuscitation

Last reviewed 01/2018

Hypertonic saline is used in burns resuscitation to reduce the total volume of fluid administered for major injuries. Excess sodium concentration in the fluid causes water to be drawn out of cells into the interstitial space. This may have the effect of decreasing the systemic vascular resistance.

However, there are problems:

• excess sodium retention
• hypernatraemia
• excess natriuresis; urine output becomes an unreliable index of tissue perfusion
• does not reduce oedema in non-burned tissue compared to colloid

The fluid regimen used is the Parkland Formula but frequently less fluid than the estimate is required.

Plasma sodium concentration should not rise above 160 mmol/l.