Pediatric emergency medicine trisk 3646 3646

If the above measures are not adequate to control ICP, hyperosmolar therapy may be necessary to control cerebral perfusion pressure Hypertonic (3%) saline may be used in the acute setting with bolus doses of to 10 mL/kg of weight Continuous infusions of hypertonic saline may be necessary to maintain ICP less than 20 mm Hg with doses starting at 0.1 mL/kg of weight that may need to be increased incrementally to 1.0 mL/kg of weight per hour, titrated to keep target serum sodium levels between 145 and 155 mEq/L Serum osmolarity should be monitored and maintained at less than 360 mOsm/L In conjunction with hyperosmolar therapy, externalization of CSF drainage by placement of a ventricular catheter may be necessary to monitor and adjust ICP to maintain ICP