Clinical review: Hypertonic saline resuscitation in sepsis.
The present review discusses the hemodynamic effects of hypertonic saline in experimental shock and in patients with sepsis. We comment on the mechanisms of action of hypertonic saline, calling upon data in hemorrhagic and septic shock. Specific actions of hypertonic saline in severe sepsis and septic shock are highlighted. Data are available that support potential benefits of hypertonic saline infusion in various aspects of the pathophysiology of sepsis, including tissue hypoperfusion, decreased oxygen consumption, endothelial dysfunction, cardiac depression, and the presence of a broad array of proinflammatory cytokines and various oxidant species. The goal of research in this field is to identify reliable therapies to prevent ischemia and inflammation, and to reduce mortality.
Oliveira
Roselaine P
RP
Department of Critical Care Medicine, Santa Casa Hospital, Federal University of Rio Grande do Sul, Porto Alegra, Brazil.
Velasco
Irineu
I
Soriano
Francisco Garcia
FG
Friedman
Gilberto
G
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000818:Animals; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007038:Hypotonic Solutions / Q000627:therapeutic use*; D008954:Models, Biological; D009200:Myocardial Contraction / Q000187:drug effects; D012151:Resuscitation / Q000379:methods*; D018805:Sepsis / Q000188:drug therapy* / Q000503:physiopathology; D012771:Shock, Hemorrhagic / Q000188:drug therapy* / Q000503:physiopathology; D012965:Sodium Chloride / Q000627:therapeutic use*
D000276:Adjuvants, Immunologic; D007038:Hypotonic Solutions; D012965:Sodium Chloride