[Is there any place for hypertonic saline for fluid resuscitation in septic shock].
Fluid loading is the first step, necessary to care for severe sepsis. Two main classes of solutions are currently available: crystalloids and colloids. The concept of small volume resuscitation with hypertonic saline has emerged these last years in the care of traumatic haemorrhagic shock. The main benefits are the restoration of intravascular volume, improvement of cardiac output and improvement of regional circulations. Many experiments highlight modulation of immune and inflammatory cascades. We report the mechanisms of action of hypertonic saline based on experimental human and animal studies, which advocate its use in septic shock.
Libert
N
N
Service de réanimation, hôpital d'instruction de armées du Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France.
de Rudnicki
S
S
Cirodde
A
A
Thépenier
C
C
Mion
G
G
D000818:Animals; D002448:Cell Adhesion / Q000187:drug effects; D002986:Clinical Trials as Topic; D004353:Drug Evaluation, Preclinical; D004487:Edema / Q000517:prevention & control; D004730:Endothelium, Vascular / Q000187:drug effects; D005440:Fluid Therapy; D006439:Hemodynamics / Q000187:drug effects; D054884:Host-Pathogen Interactions / Q000187:drug effects; D006801:Humans; D007107:Immune System / Q000187:drug effects; D007249:Inflammation / Q000188:drug therapy / Q000503:physiopathology; D007962:Leukocytes / Q000187:drug effects; D020935:MAP Kinase Signaling System / Q000187:drug effects; D009102:Multiple Organ Failure / Q000209:etiology / Q000517:prevention & control; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D015532:Rehydration Solutions / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012151:Resuscitation / Q000379:methods; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012772:Shock, Septic / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D013552:Swine
D010952:Plasma Substitutes; D015532:Rehydration Solutions; D012462:Saline Solution, Hypertonic