Hypertonic saline + epinephrine

Hypertonic saline + epinephrine is a combination therapy consisting of a concentrated sodium chloride solution (typically 3% or higher) and the adrenergic agonist epinephrine. This combination is used in two main clinical contexts: - As a nebulized treatment for acute moderate bronchiolitis in infants, where it has been shown to reduce hospital stay and improve clinical severity scores compared to hypertonic saline alone[1][4][5][6]. - As an endoscopic local injection for hemostasis in upper gastrointestinal bleeding, where the mixture (commonly 3.6% or 7.1% sodium chloride with 0.005% epinephrine) is injected around bleeding vessels to arrest hemorrhage, particularly from gastric and duodenal ulcers[2]. Mechanistically, hypertonic saline acts osmotically to draw fluid out of edematous airway tissues or mucosa, while epinephrine stimulates alpha-adrenergic receptors causing vasoconstriction (reducing edema and bleeding), as well as beta-adrenergic receptors leading to bronchodilation[8]. The combination leverages both the physical effects of osmotic dehydration and the pharmacological effects of adrenergic stimulation.

Other names

hypertonic saline-epinephrine solutionHS + epinephrine