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3% NaCl Solution (3% hypertonic saline) is a concentrated intravenous sodium chloride solution used as a perioperative fluid therapy agent. It is hypertonic relative to normal physiological saline (0.9%) and acts as an osmotic buffer, drawing fluid from the extracellular space into the intravascular compartment to sustain tissue perfusion with lower total fluid volumes. Thomas Jefferson University investigated this solution in the HYSLAR trial (NCT01428050), a prospective, randomized, double-blind controlled trial evaluating a restrictive fluid regimen using 3% hypertonic saline versus standard lactated Ringer's in patients undergoing pancreaticoduodenectomy (Whipple surgery). The trial demonstrated a statistically significant 25% reduction in postoperative complications in the hypertonic saline group compared to the standard fluid group.
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