Clinical Tools & Calculators

Hypertonic Saline 3%‎

For educational use. This tool is intended for reference and education. All care decisions require a direct clinical assessment of the patient and independent verification of doses and values by the treating team. The calculation runs locally in your browser, no patient data is sent to any server.

Hypertonic Saline 3%‎

An alternative (or an adjunct) to mannitol for ICP control. Preferred in hypovolaemic or renally impaired patients. A central line is preferred, but a short peripheral bolus is acceptable in an emergency.

100
mL (bolus)
Target Na⁺ 145–160 mEq/L
Clinical notes:
  • Monitor Na⁺ q4–6h; max correction rate 0.5 mEq/L/hr to avoid osmotic demyelination / brain shrinkage.
  • Monitor osmolality – hold if > 360 mOsm/kg.
  • If baseline hyponatremic (chronic), correct much more slowly.
  • Central line preferred for continuous infusion.
  • Monitor for fluid overload and pulmonary edema.

Reference: Kochanek PM, et al. Pediatric severe TBI guidelines, 3rd ed. Pediatr Crit Care Med 2019;20(3S):S1–S82. PMID 30829890 · doi:10.1097/PCC.0000000000001735

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