Hypertonic Saline In Stabilized Hyperdynamic Sepsis

Title

Hypertonic Saline In Stabilized Hyperdynamic Sepsis

Creator

Hannemann L; Reinhart K; Korell R; Spies C; Bredle D L

Publisher

Shock

Date

1996
1996-02

Description

Hypertonic saline with or without colloidal solution has been successfully used for treating hemorrhagic shock in animal experiments and clinical studies. Due to its various effects at systemic, organ, and microcirculatory levels, the substance appears to be a promising candidate for improving tissue oxygenation in sepsis. We therefore investigated the hypothesis that infusion of hypertonic saline would further improve O-2 delivery, O-2 extraction, and O-2 uptake in hyperdynamic septic shock patients already stabilized by adequate volume and catecholamine infusion. Twenty-one patients received 2-4 mL/kg body weight of hypertonic saline in hydroxyethyl starch within 15 min. This hypertonic saline infusion caused a rapid significant increase in O-2 delivery by 14% but only a marginal increase in O-2 consumption (7% by cardiovascular Fick [p < .05], 4% by respiratory gases [n.s.]). Hypertonic saline increased the already elevated cardiac output by 24%. The pulmonary capillary wedge pressure increased from 14 +/- 3 to 23 +/- 3 mmHg and pulmonary shunt fraction increased 15%, but arterial PO2 did not fall. Except for the increase in pulmonary capillary wedge pressure, none of the cardiovascular changes lasted longer than 60 min. Plasma sodium levels increased from 138 +/- 25 to 163 +/- 38 mmol/L and normalized within 24 h. In these hyperdynamic septic patients, hypertonic saline infusion produced a transient increase in circulation, but no evidence of a substantial increase in O-2 consumption. Either there was no significant O-2 debt due to the already elevated O-2 delivery levels at baseline (700 mL/min/m(2)) or the global O-2 measurements we used were not able to detect discrete regional hypoxia.

Subject

& Cardiology; cardiac-output; Cardiovascular System; delivery; dogs; fluid resuscitation; General & Internal Medicine; Hematology; hyperosmotic nacl; osmolality; oxygen consumption; respiratory-distress syndrome; septic shock; severe hemorrhagic-shock; Surgery

Format

Journal Article or Conference Abstract Publication

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Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

130-134

Issue

2

Volume

5

Citation

Hannemann L; Reinhart K; Korell R; Spies C; Bredle D L, “Hypertonic Saline In Stabilized Hyperdynamic Sepsis,” NEOMED Bibliography Database, accessed June 21, 2021, https://neomed.omeka.net/items/show/10072.

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