title: Effect of hypertonic saline pre-treatment on ischemia-reperfusion lung injury in pig.
abstract: BACKGROUND
  Hypertonic saline may be administered in the setting of lung transplantation but may affect the development of ischemia-reperfusion lung injury. This study investigated the effects of the pre-treatment by intravenous hypertonic saline in a pig model of single lung ischemia-reperfusion.
  
  
  METHODS
  Forty-three pigs (34 +/- 4 kg) under mechanical ventilation were randomly assigned to a left lung ischemia-reperfusion alone or preceded by 4-ml/kg 7.5% hypertonic saline, 33-ml/kg normal saline, or by the infusion of the vasodilator nicardipine. Animals without ischemia served as controls. After euthanasia, the left lung was sampled for histologic analysis and measurement of lung water and alveolar-capillary permeability.
  
  
  RESULTS
  Ischemia-reperfusion resulted in high-permeability pulmonary edema, hypoxemia, and increased interleukin-6 serum level. Hypertonic saline pre-treatment worsened pulmonary edema of the left lung (6.6 +/- 0.7 vs 4.8 +/- 0.8 ml/kg of body weight, p < 0.05) and resulted in a higher ratio of the protein level in the alveolar fluid to the serum protein level (0.41 +/- 0.04 vs 0.21 +/- 0.09, p < 0.05) and in a higher histologic damage score (11 [range, 9-11.75] vs 6.5 [range, 4.5-7.5], p < 0.05) without promoting pulmonary or systemic inflammation. Lung injury was affected neither by normal saline nor by nicardipine pre-treatment. Nicardipine did not influence the deleterious effect of hypertonic saline.
  
  
  CONCLUSIONS
  Pre-treatment by intravenous hypertonic saline worsened ischemia-reperfusion lung injury independently of its effects on the cardiac index or pulmonary circulation but probably through a direct effect of hyperosmolarity on endothelial permeability.
authors.affiliation: Service de Réanimation, Hôpitaux Sud, Marseille, France. antoine.roch@ap-hm.fr
authors.forename: Antoine
authors.initials: A
authors.lastname: Roch
authors.forename: Matthias
authors.initials: M
authors.lastname: Castanier
authors.forename: Vincent
authors.initials: V
authors.lastname: Mardelle
authors.forename: Delphine
authors.initials: D
authors.lastname: Trousse
authors.forename: Valérie
authors.initials: V
authors.lastname: Marin
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Avaro
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Tasei
authors.forename: Dorothée
authors.initials: D
authors.lastname: Blayac
authors.forename: Pierre
authors.initials: P
authors.lastname: Michelet
authors.forename: Thierry
authors.initials: T
authors.lastname: Fusai
authors.forename: Laurent
authors.initials: L
authors.lastname: Papazian