title: Sepsis volume reposition with hypertonic saline solution.
abstract: The present review discusses the hemodynamic and immune-modulatory effects of hypertonic saline in experimental shock and in patients with sepsis. We comment on the mechanisms of action of hypertonic saline, calling upon data in hemorrhagic and septic shock. Specific actions of hypertonic saline applicable to severe sepsis and septic shock are highlighted. Data available support potential benefits of hypertonic saline infusion in various aspects of the pathophysiology of sepsis, including tissue hypoperfusion, decreased oxygen consumption, endothelial dysfunction, cardiac depression, and the presence of a broad array of pro-inflammatory cytokines and various oxidant species. A therapy that simultaneously blocks the damaging components of sepsis will have an impact on the management of sepsis. Proper designed prospective studies may prove a beneficial role for hypertonic saline solution in the future.
authors.affiliation: Departamento de Clínica Médica, Faculdade Federal de Ciências Medicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Friedman
authors.affiliation: Departamento de Clínica Médica, Faculdade Federal de Ciências Medicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil.
authors.forename: Francisco Garcia
authors.initials: FG
authors.lastname: Soriano
authors.affiliation: Clínica Médica, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Ester Correia Sarmento
authors.initials: EC
authors.lastname: Rios