Hypertonic saline improves tissue oxygenation and reduces systemic and pulmonary inflammatory response caused by hemorrhagic shock.
BACKGROUND
The treatment of hemorrhagic shock (HeS) with large volumes of fluid does not ensure an adequate peripheral perfusion or prevent inflammatory activation despite hemodynamic recovery. The purpose of this study was to compare the effect of hypertonic saline (HTS) and isotonic saline (IS) solutions on oxygenation, perfusion, tumor necrosis factor-alpha and interleukin-6 levels, accumulation of polymorphonuclear neutrophils, and pulmonary perivascular edema in the treatment of controlled HeS in rats.


METHODS
Wistar rats submitted to HeS for 50 minutes (mean arterial pressure, 45-50 mm Hg) were treated with IS at three times the bled volume or with 5 mL/kg HTS.


RESULTS
The animals treated with HTS presented higher oxygenation and perfusion indices (p < 0.0001); lower arterial lactate, tumor necrosis factor-alpha, and interleukin-6 levels (p < 0.0001); less pulmonary perivascular edema and polymorphonuclear neutrophil sequestration (p < 0.0001); and lower mortality (p < 0.01) than those that received IS.


CONCLUSIONS
HTS improved tissue oxygenation and perfusion and reduced systemic and pulmonary inflammatory responses compared with IS in the treatment of HeS in rats.
Gurfinkel
Valter
V
Department of Clinical Emergencies, Hospital das Clínicas, University of São Paulo, Brazil. valter@vgi.com.br
Poggetti
Renato Sérgio
RS
Fontes
Belchor
B
da Costa Ferreira Novo
Fernando
F
Birolini
Dario
D
D000818:Animals; D001784:Blood Gas Analysis; D001794:Blood Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005440:Fluid Therapy; D007249:Inflammation / Q000097:blood / Q000209:etiology* / Q000517:prevention & control*; D015850:Interleukin-6 / Q000097:blood; D007552:Isotonic Solutions / Q000008:administration & dosage; D019344:Lactic Acid / Q000097:blood; D008168:Lung / Q000473:pathology; D008297:Male; D023421:Models, Animal; D009994:Osmolar Concentration; D010100:Oxygen / Q000378:metabolism; D010101:Oxygen Consumption / Q000187:drug effects*; D051381:Rats; D017208:Rats, Wistar; D012151:Resuscitation / Q000295:instrumentation; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D012771:Shock, Hemorrhagic / Q000097:blood / Q000150:complications* / Q000517:prevention & control*; D012964:Sodium / Q000097:blood; D016019:Survival Analysis; D014018:Tissue Distribution / Q000187:drug effects; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D015850:Interleukin-6; D007552:Isotonic Solutions; D012462:Saline Solution, Hypertonic; D014409:Tumor Necrosis Factor-alpha; D019344:Lactic Acid; D012964:Sodium; D010100:Oxygen