Dose Response Effects of Hypertonic Saline and Dextran on Cardiovascular Responses and Plasma Volume Expansion in Sheep

Dubick, Michael A.; Davis, Jessica; Myers, Tamara; Wade, Charles E.; Kramer, George C.

doi:10.1097/00024382-199503020-00009

Cited by 6 publications

(6 citation statements)

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“…The administration of hypertonic solution alone or in dextran increased the PaCO 2 and reduced arterial pH significantly shortly after resuscitation of hemorrhagic shock. This was due to the brief acidemia caused, mainly, by the hyperchloremia, hypokalemia, and metabolic acidosis without anion gap, secondary to respiratory acidosis caused by elevated PaCO 2 46,47 . In our study, the worsening of the acidosis in the initial stages of resuscitation was probably due to a possible hyperchlo-remia caused by the administration of hypertonic solution, without enough time for its recovery.…”

Section: Resultsmentioning

confidence: 99%

Efeitos hemodinâmicos e metabólicos imediatos determinados pelas soluções de cloreto de sódio a 7,5% e de sua associação ao dextran 70 a 6% na reanimação do choque hemorrágico: estudo experimental em cães

Meletti¹,

Bráz²,

Módolo³

2006

Rev. Bras. Anestesiol.

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Section: Resultsmentioning

confidence: 99%

Efeitos hemodinâmicos e metabólicos imediatos determinados pelas soluções de cloreto de sódio a 7,5% e de sua associação ao dextran 70 a 6% na reanimação do choque hemorrágico: estudo experimental em cães

Meletti¹,

Bráz²,

Módolo³

2006

Rev. Bras. Anestesiol.

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“…This result is in agreement with other clinical and experimental studies that have shown that in contrast to patients with hemorrhagic shock, the blood pressure remains unaffected or even decreases after hypertonic saline, probably because of a reactive decrease in the peripheral resistance. 21,27,28 In a previous study, we evaluated the effects of hypertonic saline combined with HS-HES compared with standard treatment with mannitol. 8 Although the results of the 2 studies can be compared only with great caution, inclusion criteria and treatment modalities were nearly identical (7.5 g sodium chloride was infused over 15 minutes in both studies).…”

Section: Discussionmentioning

confidence: 99%

Effects of Hypertonic (10%) Saline in Patients With Raised Intracranial Pressure After Stroke

Schwarz

Georgiadis

Aschoff

et al. 2002

Stroke

187

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Background and Purpose-The aim of this study was to evaluate the effects of hypertonic saline in stroke patients with increased intracranial pressure (ICP) after conventional therapy with mannitol had failed. Methods-Twenty-two episodes of ICP crisis occurred in 8 patients in whom the standard treatment of 200 mL of 20% mannitol was not effective. ICP crisis was defined as an increase in ICP of 20 mm Hg (nϭ18), pupillary abnormality (nϭ3), or a combination of both (nϭ1). The patients were treated with 75 mL of 10% saline over the course of 15 minutes. ICP, mean arterial blood pressure, and cerebral perfusion pressure were monitored for 4 hours. Blood gases, hematocrit, hemoglobin, pH, osmolarity, and electrolytes levels were measured before and 15 and 60 minutes after the start of infusion. Treatment was regarded as effective if ICP decreased Ͼ10% or the pupillary reaction had normalized. Results-Treatment was effective in all 22 episodes. The maximum ICP decrease was 9.9 mm Hg 35 minutes after the start of infusion. Thereafter, ICP began to rise again. There was no constant effect on mean arterial blood pressure, whereas cerebral perfusion pressure was consistently increased. Blood osmolarity rose by 9 mmol/L and serum sodium by 5.6 mmol/L. Potassium levels, hemoglobin, hematocrit, and pH were slightly decreased. No unexpected side effects were noted. Conclusions-Infusion of 75 mL hypertonic (10%) saline decreases elevated ICP and increases cerebral perfusion pressure in stroke patients in whom mannitol had failed. The effect on the ICP and cerebral perfusion pressure reaches its maximum after the end of infusion and is seen for 4 hours.

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“…6,7,27,31,41 Similarly, in contrast to patients with hemorrhagic shock, HS-HES does not increase SABP in euvolemic patients. 22,42,43 Mechanisms of HS-HES are complex, because HS-HES consists of 2 components: sodium chloride, which is mainly responsible for the osmotic gradient, and HES, which is added to maintain the short-lived volume effect of hypertonic saline. Similar to mannitol, the postulated mechanisms of HS-HES, aside from osmotic dehydration of brain tissue, include improved cerebral blood flow, increased oxygen delivery and rheology, and clearance of toxic metabolites from the brain.…”

Section: Discussionmentioning

confidence: 99%

Effects of Hypertonic Saline Hydroxyethyl Starch Solution and Mannitol in Patients With Increased Intracranial Pressure After Stroke

Schwarz

Schwab

Bertram

et al. 1998

Stroke

232

137

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Background and Purpose-The purpose of this study was to prospectively evaluate a protocol with hypertonic saline hydroxyethyl starch (HS-HES) and mannitol in stroke patients with increased intracranial pressure (ICP). Methods-We studied 30 episodes of ICP crisis in 9 patients. ICP crisis was defined as (1) a rise of ICP of more than 25 mm Hg (nϭ22), or (2) pupillary abnormality (nϭ3), or (3) a combination of both (nϭ5). Baseline treatment was performed according to a standardized protocol. For initial treatment, the patients were randomly assigned to either infusion of 100 mL HS-HES or 40 g mannitol over 15 minutes. For repeated treatments the 2 substances were alternated. ICP, blood pressure, and cerebral perfusion pressure (CPP) were monitored over 4 hours. Blood gases, hematocrit, blood osmolarity, and sodium were measured before and 15 and 60 minutes after the start of infusion. Treatment was regarded as effective if ICP decreased Ͼ10% below baseline value or if the pupillary reaction had normalized. Results-Treatment

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Dose Response Effects of Hypertonic Saline and Dextran on Cardiovascular Responses and Plasma Volume Expansion in Sheep

Cited by 6 publications

References 0 publications

Efeitos hemodinâmicos e metabólicos imediatos determinados pelas soluções de cloreto de sódio a 7,5% e de sua associação ao dextran 70 a 6% na reanimação do choque hemorrágico: estudo experimental em cães

Efeitos hemodinâmicos e metabólicos imediatos determinados pelas soluções de cloreto de sódio a 7,5% e de sua associação ao dextran 70 a 6% na reanimação do choque hemorrágico: estudo experimental em cães

Effects of Hypertonic (10%) Saline in Patients With Raised Intracranial Pressure After Stroke

Effects of Hypertonic Saline Hydroxyethyl Starch Solution and Mannitol in Patients With Increased Intracranial Pressure After Stroke

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