Administration of 3% Sodium Chloride Via a Peripheral Vein A Literature Review

Three percent sodium chloride (3% NaCl) is a hyperosmolar agent that can be lifesaving for patients with severe hyponatremic encephalopathy, traumatic brain injury, and cerebral edema. Until recently, many institutions restricted the infusion of 3% NaCl to a central venous site to avoid infusion related adverse events (IRAEs) in peripheral veins. A growing number of studies have reported relatively safe administration of 3% NaCl through a peripheral vein. The incidences of IRAEs were evaluated in 9 studies that included 837 patients who received 3% NaCl through a peripheral vein. Infusion reactions were either uncommon or no more frequent than with routine solutions. The authors provide guidelines for the administration of and monitoring for complications associated with 3% NaCl through a peripheral vein, discuss the management of symptomatic hyponatremia, and provide illustrative cases.

Automated summary

For patients with severe hyponatremic encephalopathy, traumatic brain injury, and cerebral edema, 3% sodium chloride can be a life-saving agent. Recent studies have shown relatively safe administration of 3% sodium chloride through a peripheral vein, with infusion reactions being uncommon or no more frequent than with routine solutions. The authors provide guidelines for administration and monitoring of complications, discuss the management of symptomatic hyponatremia, and provide illustrative cases.