title: Hypertonic saline improves tissue oxygenation and reduces systemic and pulmonary inflammatory response caused by hemorrhagic shock.
abstract: 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.
authors.affiliation: Department of Clinical Emergencies, Hospital das Clínicas, University of São Paulo, Brazil. valter@vgi.com.br
authors.forename: Valter
authors.initials: V
authors.lastname: Gurfinkel
authors.forename: Renato Sérgio
authors.initials: RS
authors.lastname: Poggetti
authors.forename: Belchor
authors.initials: B
authors.lastname: Fontes
authors.forename: Fernando
authors.initials: F
authors.lastname: da Costa Ferreira Novo
authors.forename: Dario
authors.initials: D
authors.lastname: Birolini
mesh_terms: 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
chemical_list: D015850:Interleukin-6; D007552:Isotonic Solutions; D012462:Saline Solution, Hypertonic; D014409:Tumor Necrosis Factor-alpha; D019344:Lactic Acid; D012964:Sodium; D010100:Oxygen