Resuscitation of pulmonary contusion: hypertonic saline is not beneficial.
We postulated that hypertonic solutions could minimize the accumulation of lung water and subsequent respiratory derangements that occur after pulmonary contusion. Anesthetized pigs underwent contusion of the right chest at baseline and then were hemorrhaged (30 cc/kg) over 20 min. They were resuscitated with either 7.5% NaCl (4 cc/kg) or .9% saline (90 cc/kg) for 20 min and observed for 4 h. Gravimetric lung weights and spiral computed tomography scans were used to quantitate lung water. The hemodynamic response to contusion and hemorrhage was similar in both resuscitation groups. Arterial oxygen tension was not significantly altered by the method of resuscitation and remained close to baseline values for the entirety of the experiment. Static compliance measurements were significantly decreased from baseline in both groups following pulmonary contusion. There were no differences in wet to dry lung weights or computed tomography scan injury volume between groups. We conclude that small volume hypertonic saline resuscitation does not reduce the magnitude of lung injury or provide substantial physiologic benefit over isotonic solutions following pulmonary contusion.
Cohn
S M
SM
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06520, USA.
Fisher
B T
BT
Rosenfield
A T
AT
Cross
J H
JH
D000818:Animals; D001692:Biological Transport / Q000187:drug effects; D003288:Contusions / Q000188:drug therapy* / Q000503:physiopathology; D000077324:Crystalloid Solutions; D015633:Extravascular Lung Water / Q000187:drug effects; D005440:Fluid Therapy / Q000009:adverse effects; D006439:Hemodynamics / Q000187:drug effects; D007552:Isotonic Solutions; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D055370:Lung Injury; D008297:Male; D010100:Oxygen / Q000097:blood; D010952:Plasma Substitutes / Q000008:administration & dosage; D015532:Rehydration Solutions / Q000008:administration & dosage; D012129:Respiratory Function Tests; D012151:Resuscitation; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage* / Q000009:adverse effects; D013552:Swine
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D015532:Rehydration Solutions; D012462:Saline Solution, Hypertonic; D010100:Oxygen