Efficacy and safety of rapid intermittent bolus compared with slow continuous infusion in patients with severe hypernatremia (SALSA II trial): a study protocol for a randomized controlled trial

• Published in: Kidney research and clinical practice Vol. 41; no. 4; pp. 508 - 520
• Main Authors: Ryu, Ji Young, Yoon, Songuk, Lee, Jeonghwan, Baek, Sumin, Jo, You Hwan, Ko, Kwang-Pil, Sim, Jin-Ah, Han, Junhee, Kim, Sejoong, Baek, Seon Ha
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Nephrology 01.07.2022; 대한신장학회
• Subjects: brain edema; hypernatremia; hypotonic solutions; Study Protocol; therapeutics; 내과학; Treatment; Cerebral edema; Electrolyte-free water; Hypernatremia; Hypotonic solution
• ISSN: 2211-9132; 2211-9140
• DOI: 10.23876/j.krcp.21.193

Hypernatremia is a common electrolyte disorder in children and elderly people and has high short-term mortality. However, no high-quality studies have examined the correction rate of hypernatremia and the amount of fluid required for correction. Therefore, in this study, we will compare the efficacy and safety of rapid intermittent bolus (RIB) and slow continuous infusion (SCI) of electrolyte-free solution in hypernatremia treatment. This is a prospective, investigator-initiated, multicenter, open-label, randomized controlled study with two experimental groups. A total of 166 participants with severe hypernatremia will be enrolled and divided into two randomized groups; both the RIB and SCI groups will be managed with electrolyte-free water. We plan to infuse the same amount of fluid to both groups, for 1 hour in the RIB group and continuously in the SCI group. The primary outcome is a rapid decrease in serum sodium levels within 24 hours. The secondary outcomes will further compare the efficacy and safety of the two treatment protocols. This is the first randomized controlled trial to evaluate the efficacy and safety of RIB correction compared with SCI in adult patients with severe hypernatremia.