Acute haemodynamic effects of a hypertonic saline/dextran solution in stable patients with severe sepsis

Rp, Oliveira; Weingartner, Roger; Eo, Ribas; Rs, Moraes; Friedman, Gilberto

doi:10.1007/s00134-002-1509-x

Cited by 61 publications

(5 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From a clinical perspective, Hannemann et al 20 conducted the first study on the effect of small volume resuscitation in severe sepsis. Oliveira et al 21 reported that an HTS/dextran solution improved cardiovascular performance and resuscitated patients with severe sepsis through a volume effect, but may also directly improve cardiac function.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Hypertonic Saline on mRNA of Proinflammatory Cytokines in Lipopolysaccharide-Stimulated Polymorphonuclear Cells

Choi

Yoon

Kim

et al. 2014

Current Therapeutic Research

View full text Add to dashboard Cite

BackgroundHypertonic saline is often used to resuscitate patients experiencing shock. In such conditions, polymorphonuclear cells and Toll-like receptors (TLRs) form an essential part of early induced innate immunity.ObjectiveTo investigate the immunomodulatory effect of hypertonic saline on polymorphonuclear cells by evaluating the changes in TLR-4 receptors and proinflammatory cytokines.MethodsPolymorphonuclear cells were isolated from whole blood using Polymorphprep (Axis-Shield, Oslo, Norway). The isolated polymorphonuclear cells were plated at a density of 1 × 106 cells/mL in 6-well flat-bottomed culture plates and were stimulated with 1 μg/mL lipopolysaccharide or N-formyl-methionyl-leucyl-phenylalanine. The stimulated polymorphonuclear cells were cultured in hypertonic saline at 10, 20, or 40 mmol/L above isotonicity. After that, the changes in TLR-4 and cytokines were measured by quantitative real-time polymerase chain reaction and flow cytometry.ResultsThe level of TLR-4 mRNA expression decreased after stimulation with N-formyl-methionyl-leucyl-phenylalanine, but hypertonic saline did not affect the TLR-4 mRNA expression. TLR-4 mRNA expression was clearly induced upon stimulation with lipopolysaccharide, and the addition of hypertonic saline restored TLR-4 mRNA expression in polymorphonuclear cells. The interleukin-1β mRNA expression was decreased in the hypertonic environment. On the other hand, the tumor necrosis factor-α value was not influenced by the addition of hypertonic saline.ConclusionsHypertonic saline has an immunomodulatory effect on polymorphonuclear cells through the TLR-4 pathway, and the interleukin–1β-associated pathway is influenced more by hypertonic saline than is the tumor necrosis factor–α-associated pathway.

show abstract

Section: Discussionmentioning

confidence: 99%

The Effect of Hypertonic Saline on mRNA of Proinflammatory Cytokines in Lipopolysaccharide-Stimulated Polymorphonuclear Cells

Choi

Yoon

Kim

et al. 2014

Current Therapeutic Research

View full text Add to dashboard Cite

show abstract

“…The use of 7.5% HTS/Dextran 70 was associated with short-lived improvement in hemodynamic status in patients with severe sepsis compared to normal saline. 64 It can also improve the oxygen delivery and cardiac output in septic shock patients. 65 Effat et al used HTS in forty critically ill patients with septic shock, where it decreases CRP levels, improves in cardiac functions, sepsis scores, use of vasopressors, decreases ICU stay, and mechanical ventilation days.…”

Section: Neurogenic Shockmentioning

confidence: 99%

Use of Hypertonic Saline in Neuroanesthesia and Neurocritical Care Practice: A Narrative Review

Barik

Thappa

Jangra

et al. 2023

J Neuroanaesth Crit Care

View full text Add to dashboard Cite

Hypertonic saline (HTS) is a group of fluids containing sodium and chloride in a higher concentration as compared to physiological saline. The authors have conducted this review to evaluate the use of HTS in neuroanesthesia and neurocritical care. The articles for this narrative review on HTS were searched on databases like PubMed Central, EMBASE, and Google Scholar using the Medical Subject Headings keywords “Hypertonic Saline,” “Neuroanesthesia,” and “Neurocritical Care.” The review focuses on the mechanisms of HTS and its in routine clinical practice. The results of various comparative studies between HTS and mannitol and guidelines regarding the use of HTS have also been reviewed. HTS can be used to treat hyponatremia, reduce intracranial pressure, provide intraoperative relaxed brain, and aid in resuscitation during cardiogenic, neurogenic, and septic shock. Its side effects include renal toxicity in the case of hypernatremia, rebound intracranial hypertension, volume overload, dyselectrolytemia, phlebitis, local tissue damage, and osmotic demyelination syndrome in the case of rapid correction of serum sodium concentration.

show abstract

“…Also, human prehydration with intravenous fluid (1.5 L of 2.5% glucose/0.45% NaCl), 1 h prior to an injection of Escherichia coli purified LPS endotoxin, may shift the resulting cytokine balance towards a more anti-inflammatory pattern, with a reduction of symptoms [ 123 ] and an outcome that is similar to the successful treatment of sepsis (i.e., life-threatening organ dysfunction caused by a dysregulated host response to infection [ 47 ] via i.v. fluid [ 124 , 125 ]). To evaluate the effects of dehydration on gastrointestinal permeability, Lambert and colleagues [ 122 ] conducted a laboratory study in which twenty trained endurance athletes (11 men, 9 women) ran three times, in a 24°C mild environment, for 60 min at 70% of maximal aerobic power.…”

Section: Factors Which Increase Intestinal Permeability and Plasmamentioning

confidence: 99%

Interactions of Gut Microbiota, Endotoxemia, Immune Function, and Diet in Exertional Heatstroke

Armstrong

Lee

Armstrong

2018

Journal of Sports Medicine

View full text Add to dashboard Cite

Exertional heatstroke (EHS) is a medical emergency that cannot be predicted, requires immediate whole-body cooling to reduce elevated internal body temperature, and is influenced by numerous host and environmental factors. Widely accepted predisposing factors (PDF) include prolonged or intense exercise, lack of heat acclimatization, sleep deprivation, dehydration, diet, alcohol abuse, drug use, chronic inflammation, febrile illness, older age, and nonsteroidal anti-inflammatory drug use. The present review links these factors to the human intestinal microbiota (IM) and diet, which previously have not been appreciated as PDF. This review also describes plausible mechanisms by which these PDF lead to EHS: endotoxemia resulting from elevated plasma lipopolysaccharide (i.e., a structural component of the outer membrane of Gram-negative bacteria) and tissue injury from oxygen free radicals. We propose that recognizing the lifestyle and host factors which are influenced by intestine-microbial interactions, and modifying habitual dietary patterns to alter the IM ecosystem, will encourage efficient immune function, optimize the intestinal epithelial barrier, and reduce EHS morbidity and mortality.

show abstract

Acute haemodynamic effects of a hypertonic saline/dextran solution in stable patients with severe sepsis

Abstract: Hypertonic saline/dextran solution may improve cardiovascular performance in severe sepsis without significant side effects. The haemodynamic effect appears related mainly to a volume effect.

Cited by 61 publications

References 31 publications

The Effect of Hypertonic Saline on mRNA of Proinflammatory Cytokines in Lipopolysaccharide-Stimulated Polymorphonuclear Cells

The Effect of Hypertonic Saline on mRNA of Proinflammatory Cytokines in Lipopolysaccharide-Stimulated Polymorphonuclear Cells

Use of Hypertonic Saline in Neuroanesthesia and Neurocritical Care Practice: A Narrative Review

Interactions of Gut Microbiota, Endotoxemia, Immune Function, and Diet in Exertional Heatstroke

Contact Info

Product

Resources

About