Hemodynamic effects of hypertonic sodium chloride

Rowe, G G; McKenna, David H.; Corliss, Robert J.; Sialer, Salvador

doi:10.1152/jappl.1972.32.2.182

Cited by 61 publications

(24 citation statements)

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“…Amelhora do débito cardíaco parece ser independente da melhora da pré-carga. O aumento do débito cardíaco pode ser por efeito direto sobre a contratilidade 22 ou por extensa vasodilatação pré-capilar 10,23 . A infusão de solução hipertônica de cloreto de sódio não alterou a PAM e a PVCI, diferindo de alguns trabalhos que mostraram elevação destes parâmetros 7,10 .…”

Section: Discussionunclassified

“…Cardiac output improvement seems to be independent of preload improvement. Cardiac output increase may be caused by a direct effect on contractility 22 or by extensive pre-capillary vasodilatation 10,23 . Hypertonic sodium chloride solution infusion has not changed MBP and IVCP, differently from other studies showing increase in those parameters 7,10 .…”

Section: Discussionmentioning

confidence: 99%

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Efeitos renais e cardiovasculares da infusão de dopamina e da solução de cloreto de sódio a 7,5%: estudo experimental em cães com restrição hídrica

Verderese¹,

Vianna²,

Ganem³

et al. 2003

Rev. Bras. Anestesiol.

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Section: Discussionunclassified

Section: Discussionmentioning

confidence: 99%

Efeitos renais e cardiovasculares da infusão de dopamina e da solução de cloreto de sódio a 7,5%: estudo experimental em cães com restrição hídrica

Verderese¹,

Vianna²,

Ganem³

et al. 2003

Rev. Bras. Anestesiol.

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“…The relevance of this becomes apparent when one considers the mechanisms by which HTS is thought to restore hemodynamics: 1) by inducing an osmotic fluid shift from the intracellular to the extracellular space, resulting in intravascular expansion, 2) by decreasing total peripheral resistance, and 3) by increasing myocardial contractility. 6,[19][20][21][22] The latter two effects are believed to be directly related to the action of the sodium ion on the cardiovascular system. 23 In addition, data from Halvorsen et al suggest that, to a point, the administration of increasing amounts of sodium is associated with incremental improvement in hemodynamic parameters.…”

Section: Discussionmentioning

confidence: 99%

Resuscitation of Severe Uncontrolled Hemorrhage 7.5% Sodium Chloride/6% Dextran 70 vs 0.9% Sodium Chloride

Stern¹,

Jwayyed²,

Dronen³

et al. 2000

Academic Emergency Medicine

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Abstract.Objectives: Resuscitation studies of hypertonic saline using controlled and uncontrolled hemorrhage models yield conflicting results with regard to efficacy. These disparate results reflect the use of models and resuscitation regimens that are not comparable between studies. This study evaluated the effects of comparable and clinically relevant resuscitation regimens of 7.5% sodium chloride/6% dextran 70 (HSD) and 0.9% sodium chloride (NS) in a near-fatal uncontrolled hemorrhage model. Methods: Thirty-six swine (14.2 to 21.4 kg) with 4-mm aortic tears were bled to a pulse pressure of 5 mm Hg (40-45 mL/kg). The animals were resuscitated with either NS or HSD administered in volumes that provided equivalent sodium loads at similar rates. Group II (n = 12) was resuscitated with 80 mL/kg of NS at a rate of 4 mL/kg/min. Group III (n = 12) received 9.6 mL/ kg of HSD at a rate of 0.48 mL/kg/min. In both groups, crystalloid resuscitation was followed by shed blood infusion (30 mL/kg) at a rate of 2 mL/kg/min. Group I (controls; n = 12) were not resuscitated. Results: One-hour mortality was significantly greater in group I (92%) as compared with group II (33%) and group III (33%) (Fisher's exact test; p = 0.004). Intraperitoneal hemorrhage was significantly greater in group II (34 Ϯ 20 mL/kg) and group III (31 Ϯ 13 mL/ kg) as compared with group I (5 Ϯ 2 mL/kg) (ANOVA; p < 0.05). There was no significant difference in hemodynamic parameters between groups II and III. Conclusion: In this model of severe uncontrolled hemorrhage, resuscitation with HSD or NS, administered in volumes that provided equivalent sodium loads at similar rates, had similar effects on mortality, hemodynamic parameters, and hemorrhage from the injury site. Key words: uncontrolled hemorrhage; shock; resuscitation; hypertonic saline; hemorrhage models; pig. ACADEMIC EMERGENCY MEDICINE 2000; 7:847-856 S TANDARD management of acute life-threatening hemorrhagic hypotension includes attempts to restore blood pressure (BP) to normal or near-normal levels through rapid administration of large volumes of isotonic crystalloid. 1 An alternative resuscitation agent that has shown considerable promise is 7.5% sodium chloride (HTS), used alone or in combination with 6% dextran 70 (HSD). Several animal studies of acute hemorrhagic hypotension have demonstrated that smallvolume infusions of HTS and HSD are more effec- tive in increasing BP, increasing cardiac output, and providing volume expansion as compared with conventional isotonic crystalloids. 2-10 Based on these studies, several authors have advocated the out-of-hospital administration of hypertonic crystalloids for acute hemorrhagic shock. However, not all of the hypertonic saline studies have demonstrated improvement in outcome from resuscitation of acute hemorrhage. More recent studies demonstrate that hypertonic saline resuscitation increases hemorrhage volume and mortality, presumably the result of a rapid rise in BP. [11][12][13][14][15] The authors of the latter studies therefore caution ...

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“…The administration of HSS to hemorrhagicor endotoxic-shocked animals results in increased cardiac output, cardiac index, myocardial stroke work efficiency [1,10,11,15], and oxygen delivery [16]. In addition, mean arterial pressure (MAP) is restored, and peripheral and pulmonary vascular resistance is reduced [1,10,11,15,16]. These beneficial effects of HSS administration most likely result from an increase in preload, a decrease in afterload, or both.…”

Section: Methodsmentioning

confidence: 99%

Effect of a 7.2% Hypertonic Saline Solution Infusion on Arterial Blood Pressure, Serum Sodium Concentration and Osmotic Pressure in Normovolemic Heifers.

1998

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ABSTRACT. The effects of an intravenous (iv) infusion of a small volume (5 ml/kg) or large volume (15 ml/kg) of hypertonic saline solution (HSS; 7.2%, 2,400 mOsmol/kg·H 2 O) and those of an iv infusion of 5 ml/kg isotonic saline solution (ISS; 300 mOsmol/kg·H 2 O) on plasma volume, arterial blood pressure, serum sodium concentrations and osmotic pressure were investigated in conscious heifers. Nine heifers (3 heifers/group) were monitored for 120 min after the initiation of fluid replacement. The relative plasma volume (rPV) in the 5 ml/kg HSS and 15 ml/kg HSS progressively increased to 137.7 ± 2.4% at t=5 min and 145.2 ± 5.4% at t=15 min, respectively. The expanding plasma volume in the 5 ml/kg HSS group remained at an up to 10% higher level until 120 min, but not in the 15 ml/kg HSS group. The 5 ml/kg HSS infusion induced transit high-osmotic (305.3 ± 4.0 mOsmol/kg·H 2 O) and sodium levels (155.7 ± 3.5 mM/l) at t=5 min. However, the 15 ml/kg HSS infusion induced constant high-osmotic level (321.7-336.7 mOsmol/kg·H 2 O) and hypernatremia (162.8-170.0 mM/l) from t=10 min to the rest of the experiment period. In the ISS and 5 ml/kg HSS groups, no changes in PaO 2 were observed. The 15 ml/kg HSS infusion induced a significant decrease in the partial pressure of oxygen at the t=30 min compared to the t=0 min values. On the basis of these findings, a small volume (5 ml/kg) HSS infusion can be rapidly and safely administered to cattle for expanding the plasma volume without inducing hypernatremia. A 5 ml/kg HSS infusion is thus recommended for the initial field resuscitation of cattle. -KEY WORDS: heifer, hypernatremia, hypertonic saline solution, plasma volume, serum osmotic pressure.

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Hemodynamic effects of hypertonic sodium chloride

Cited by 61 publications

References 0 publications

Efeitos renais e cardiovasculares da infusão de dopamina e da solução de cloreto de sódio a 7,5%: estudo experimental em cães com restrição hídrica

Efeitos renais e cardiovasculares da infusão de dopamina e da solução de cloreto de sódio a 7,5%: estudo experimental em cães com restrição hídrica

Resuscitation of Severe Uncontrolled Hemorrhage 7.5% Sodium Chloride/6% Dextran 70 vs 0.9% Sodium Chloride

Effect of a 7.2% Hypertonic Saline Solution Infusion on Arterial Blood Pressure, Serum Sodium Concentration and Osmotic Pressure in Normovolemic Heifers.

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