Effect of hypertonic saline infusion on postoperative cellular immune function: a randomized controlled clinical trial.
BACKGROUND
Previous studies found hypertonicity to affect immune responses in intact laboratory animals and in human blood cell cultures. In this study, the authors investigated the cellular immune response to surgery after preoperative infusion of hypertonic saline in humans.


METHODS
Sixty-two women scheduled to undergo abdominal hysterectomy were randomly assigned to single-blinded infusion of 4 ml/kg NaCl, 7.5%; 4 ml/kg NaCl, 0.9%; or 32 ml/kg NaCl, 0.9%, over 20 min. Blood was collected at baseline, during surgery, and 1, 24, and 48 h after surgery for the determination of leukocyte and differential counts, flow cytometric phenotyping of mononuclear cells, and natural killer cell activity against K 562 tumor cells. Phytohemagglutinin-induced lymphocyte proliferation, plasma elastase, and neutrophil chemotaxis were measured at the same time points except during surgery. The authors tested cell-mediated immune function in vivo by delayed-type hypersensitivity reaction in the skin.


RESULTS
Surgery induced well-known changes in the cellular immune response, which were unrelated to the tonicity or volume of the infused fluids.


CONCLUSIONS
Infusion of a clinically relevant dose of hypertonic saline did not seem to modify the postoperative cellular immune response after elective abdominal hysterectomy.
Kølsen-Petersen
Jens A
JA
Department of Anesthesia and Intensive Care, Viborg County Hospital, Heibergs Alle 4, 8800 Viborg, Denmark. jaakp@dadlnet.dk
Nielsen
Jens-Ole D
JO
Tonnesen
Else M
EM
D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007111:Immunity, Cellular / Q000187:drug effects* / Q000276:immunology; D007262:Infusions, Intravenous; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000276:immunology; D016014:Linear Models; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D016037:Single-Blind Method
D012462:Saline Solution, Hypertonic