Module 4: Pediatric Head Injuries
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- Normal serum osmolality is 285 ± 5 msom/L
- Hypertonic saline or mannitol can be used to make the serum hyperosmolar and thus absorb free water (i.e., cerebral edema) from the brain
- 3% hypertonic NaCl dose - 10 ml/kg/day maintenance
- 20% mannitol dose - 0.25 gm/kg per dose, can be repeated up to 4 times (effect is seen in ~15 minutes)
- Monitor both serum Na+ and osmolality - goal is to keep Na+ in the 155 - 160 meq/L range and osmolality in 310 - 320 msosm/L range
- Furosemide 0.5 to 1 mg/kg can be given to promote diuresis if volume resuscitation is complete
Module 4: Pediatric Head Injuries
