title: Operating room use of hypertonic solutions: a clinical review.
abstract: Hyperosmotic-hyperoncotic solutions have been widely used during prehospital care of trauma patients and have shown positive hemodynamic effects. Recently, there has been a growing interest in intra-operative use of hypertonic solutions. We reviewed 30 clinical studies on the use of hypertonic saline solutions during surgeries, with the majority being cardiac surgeries. Reduced positive fluid balance, increased cardiac index, and decreased systemic vascular resistance were the main beneficial effects of using hypertonic solutions in this population. Well-designed clinical trials are highly needed, particularly in aortic aneurysm repair surgeries, where hypertonic solutions have shown many beneficial effects. Examining the immunomodulatory effects of hypertonic solutions should also be a priority in future studies.
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Canada. gustavo.azoubel@utoronto.ca
authors.forename: Gustavo
authors.initials: G
authors.lastname: Azoubel
authors.forename: Bartolomeu
authors.initials: B
authors.lastname: Nascimento
authors.forename: Mauricio
authors.initials: M
authors.lastname: Ferri
authors.forename: Sandro
authors.initials: S
authors.lastname: Rizoli
mesh_terms: D003911:Dextrans / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D019990:Perioperative Care; D010952:Plasma Substitutes / Q000008:administration & dosage*; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage*; D013514:Surgical Procedures, Operative; D014882:Water-Electrolyte Balance
chemical_list: D003911:Dextrans; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D012462:Saline Solution, Hypertonic