Figure 1

Dose-adaptation of continuous hypertonic saline solution infusion. The attending physician set the targets of natremia according to the intracranial pressure (ICP). The target could be modified by a step of 5 mmol/L from 145 to 155 mmol/L. Natremia and natriuresis were assessed every 4 hours. Target was considered achieved if -2 mmol/L < Delta < +2 mmol/L; otherwise, the flow of NaCl infusion was adapted. On infusion initiation or when natremia was below the target (left side), a 1-hour bolus was performed. When the target of natremia was reached (middle), the flow of a continuous infusion of HSS (NaCl 20%) was adapted to the urinary excretion of sodium, and the extraurinary sodium loss was neglected. If natremia was above the target (right side), the infusion of NaCl (20%) was discontinued for 1 hour. ‡Except in case of intracranial pressure > 20 mm Hg. Natriuresis, urinary sodium concentration (mmol/L); kaliuresis, urinary potassium concentration (mmol/L); dieresis, urinary output (ml/h); Delta, natremia - target).