Title: Hypertonic saline - safe for transport?
题目：高张盐水－转运病人时使用安全吗？
Author 作者: Mimi Lu

Management of the patient with intracranial hypertension represents one of the most challenging situations the emergency physician faces. Doing so in a community setting when the patient is a child is even more daunting. But devising therapies that can safely be given while the patient is being transferred to a tertiary center for definitive therapy is truly critical.
处理颅内压增高是急诊医生面临的严峻挑战之一，在县级以下医院处理儿科病人时会更具危险性。因此制定一个能在将病人转移到上级医院时安全使用的治疗方法尤为关键。
 
Fortunately, a recent study suggests that 3% saline fits this bill nicely. Given the risk of vasconstriction with hyperventilation and the risk of hypovolemia with mannitol, hypertonic saline has emerged as beneficial therapy when trying to decrease intracranial pressure (ICP) in both children and adults. 
可幸的是，一个新的临床研究提示3％的盐水可以满足这一要求。由于过度通气造成血管收缩和甘露醇造成低容量的危险，高张盐水已成为降低儿童和成人颅内压的有效方法。
 
In late 2011, the Loma Linda University Medical Center published a retrospective analysis of their experience using 3% saline during transport of children at risk of elevated ICPs. While they found the expected rise in electrolytes such as sodium, chloride and bicarbonate, importantly they found no adverse effects (such as "local effects, renal abnormalities or central pontine myelinolysis") related to the administration of hypertonic saline, even though 96% of patients received the infusion through a peripheral line.
2011年末，罗马林达大学医学中心发表了一个有关转运有颅内压增高危险儿童使用3％盐水的回顾性报告。虽然他们发现了在预见内的钠，氯，和碳酸氢钠增高，但没有发现于注射高张盐水有关的副作用（如局部反应，肾功异常，或脑桥中部髓鞘溶解）。96％的病人通过末梢血管接受注射。
 
Bottom line: hypertonic saline appears to be a viable and safe option for use as therapy to decrease ICH during transport of children at risk for intracranial hypertension.
要点：在转运有颅内高压危险儿童时，高张盐水是有效安全的降低颅内压的方法。
 
 
Reference 参考文献:
Luu JL, Wendtland CL, Gross MF, et al. Three percent saline administration during pediatric critical care transport. Ped Emerg Care 2011;27(12):1113-1117.