Q: What is the dose of 23.4% Saline bolus in refractory Increased Intra-Cranial Pressure (ICP)

Answer:  30 ml

30 ml of an intravenous bolus administration of 23.4% hypertonic saline reduced ICP and augmented CPP for up to 3 hours in patients with intractable elevations in ICP from diverse origins that were refractory to all conventional therapeutic modalities including hyperventilation, mannitol and barbiturates. 

References:

1. Suarez JI, Qureshi AI, Bhardwaj A, Williams MA, Schnitzer MS, Mirski M, et al: Treatment of refractory intracranial hypertension with 23.4% saline. Crit Care Med 26:1118–1122, 1998

2. Ware ML, Nemani VM, Meeker M, Lee C, Morabito DJ, Man ley GT: Effects of 23.4% sodium chloride solution in reducing intracranial pressure in patients with traumatic brain injury: a preliminary study. Neurosurgery 57:727–736, 2005