Analyzing the efficacy of frequent sodium checks during hypertonic saline infusion after elective brain tumor surgery

- HS is not routinely used in elective brain tumor surgery.
- This study assessed the efficacy of frequent serum sodium checks in these patients.
- Sodium values did not significantly change >10 h after surgery.
- Frequent sodium checks may be less cost-effective than daily serum sodium checks.

ObjectiveTo assess the utility of frequent sodium checks (every 6 h) in patients receiving hypertonic saline (HS) after elective brain tumor surgeries.Patients and methodsA single-institution retrospective review of patients having undergone elective craniotomies for brain tumors and treated with postoperative continuous intravenous infusions of 3% HS was performed. Changes in serum sodium values were analyzed at different time points. The rates of <12.5, 25, and 50 cc/h infusions were also examined. Healthcare cost analysis was performed by extrapolating our cohort to the total number of craniotomies performed in the United States.ResultsNo significant differences among sodium values checked between 0 to 4, 4-6, 6-8, 8-10, and >10 h were observed (P = .64). In addition, no differences in serum sodium values among the rates of <12.5, 25, and 50 cc/h were found (P = .30). No patients developed symptoms of acute hypernatremia.ConclusionsSerum sodium values did not significantly change more than 10 h after infusion of HS. Further studies are needed to determine the optimal frequency of routine sodium checks to increase the quality of care and decrease healthcare costs.