Fluid resuscitation is usually the first line treatment in trauma care in emergency department

Ms Mneera Alshammari1

1The University of Sydney

Background: haemorrhage induced by trauma is the leading cause for death in the world. Isotonic solutions represent first-line management in fluid resuscitation. The infusion of hypertonic saline (HS) for trauma patients with hemorrhage might provide many benefits, as demonstrated by animal studies into the safety and effectiveness of managing hemorrhage. Thus, its efficacy on managing hemorrhagic patients remains unknown.

Objective: this integrative review aimed to evaluate the effectiveness of hypertonic saline in fluid resuscitation for trauma patients with hemorrhage.

Methods: the study relied on an integrative review using the CINHAL and Medline databases. The reviewer began by dividing the research question into keywords and synonyms in order to facilitate the research process. The final review included eight studies (total of 2,333 patients enrolled) that have been described and appraised for quality of evidence.

Results: The findings demonstrate the impacts of hypertonic saline on maintaining a high level of blood pressure and mean blood pressure. However, it also includes variations in opinion regarding the efficacy of HS on improving survival rates. Although neurological status does not appear to improve after using HS, its administration during fluid resuscitation can maintain anti-inflammatory effects and attenuate multi-organ dysfunction.

Conclusion: hypertonic saline appears to be safe for use in fluid resuscitation, ensuring hemodynamic stability and demonstrating anti-inflammatory effects. However, it cannot be recommended as a first-line solution for fluid resuscitation in trauma patients with hemorrhage due to the lack of consensus regarding its effect on survival and mortality rates.


Mneera is a lecturer in and clinical instructor since 2013 in nursing college, University of hail, Saudi Arabia. Mneera has her post graduate qualification of Master of Emergency Nursing from The University of Sydney in 2018. She is providing lectures and working as clinical facilitator for undergraduate students. Her experience in emergency department and intensive care unit. She has strong interest in trauma care.