*can't sleep, got bored, and wandered over from pre-vet forum*
Actually, there are a couple cases where hypertonic solutions might be used, which I will try to explain using my limited medical knowledge:
- In the case of cerebral edema, hypertonic saline is sometimes used along with osmotic diuretics, etc., to draw water out of the CNS and back into the bloodstream.
- In the setting of hypovolemic or septic shock, hypertonic saline draws water into the vascular space rapidly, supporting circulation and perfusion of vital organs. It is always followed immediately by large amounts of isotonic solutions, so that cellular dehydration does not last long. There is some thought that hypertonic saline may have other effects, such as protecting capillary endothelium and reducing expression of inflammatory mediators, etc.
Where I work, horses who show up extremely dehydrated (usually due to intestinal lesions) and in shock often receive 1-2L of 7% NaCl as part of aggressive resuscitation, usually followed by 30-50L of polyionic isotonic fluids (this is for a 500 kg horse).