Dynamic fluid redistribution in hyperosmotic resuscitation of hypovolemic hemorrhage

Mazzoni, Michelle C.; Borgström, Per; Arfors, K. E.; Intaglietta, Marcos

doi:10.1152/ajpheart.1988.255.3.h629

Cited by 129 publications

(115 citation statements)

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“…The beneficial effects of a 7.2% hypertonic saline solution (HSS; 2,400 mOsmol/kg·H 2 O) on cardiopulmonary function in dogs with hemorrhage shock [9,10,14,15,23] were reported. Several possibilities concerning the mechanisms of beneficial effects of a HSS intravenous (IV) infusion have been proposed, as follows.…”

Section: Methodsmentioning

confidence: 99%

“…Several possibilities concerning the mechanisms of beneficial effects of a HSS intravenous (IV) infusion have been proposed, as follows. One possibility is the expansion of circulating volume [2,3,8,10,13,14,[18][19][20]. A 140 ml infusion of HSS can drew 575 ml and 285 ml of water from interstitial and intracellular fluid compartments, respectively; the expanding plasma volume thus reached 1,000 ml [8].…”

Section: Methodsmentioning

confidence: 99%

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Effect of Intravenous Infusion of a 7.2% Hypertonic Saline Solution on Serum Electrolytes and Osmotic Pressure in Healthy Beagles.

Ajito

Suzuki

Iwabuchi

1999

The Journal of Veterinary Medical Science

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ABSTRACT. The effect of an intravenous (IV) infusion of hypertonic saline solution (HSS; 7.2%, 2,400 mOsmol/kg·H 2 O) was evaluated by serum electrolyte concentrations and osmotic pressure in the anesthetized beagles. Sixteen beagles were assigned to 3 experimental groups (2.5, 5 or 15 ml/kg of HSS IV infusion) or a control group (5 ml/kg of isotonic saline solution (ISS) IV infusion) and were monitored for 120 min after the initiation of fluid infusion. The relative plasma volume (rPV) in the 5 ml/kg and 15 ml/kg HSS groups progressively expanded to 143.1 ± 7.4% at 3 min and 156.4 ± 5.9% at 5 min after the initiation of the fluid infusion, respectively. Significant increases were not produced by ISS and 2.5 ml/kg HSS infusion. The serum sodium and chloride concentrations in the ISS group were not altered. The 5 ml/kg HSS infusion induced transient high osmotic and sodium levels, and the serum sodium concentration remained under the 160 mM/l after the completion of the HSS infusion. However, the 15 ml/kg HSS infusion induced a constant high osmotic level (340.5-352.8 mOsmol/kg·H 2 O) and hypernatremia (161.4-174.5 mM/l) from 10 to 90 min after the initiation of the fluid infusion. The 15 ml/kg HSS infusion induced significant decreases in the partial pressure of oxygen (PaO 2 ), reaching 63.7 ± 8.0 mmHg at 120 min after the initiation of the fluid infusion compared with an immediately before fluid infusion value. On the basis of these findings, 5 ml/kg HSS infusion can be safely administered to healthy beagles for expanding the plasma volume without inducing hypernatremia. A 5 ml/kg HSS infusion is thus recommended for the initial field resuscitation of dogs.-KEY WORDS: arterial blood pressure, canine (beagle), hypernatremia, hypertonic saline solution, plasma volume.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Effect of Intravenous Infusion of a 7.2% Hypertonic Saline Solution on Serum Electrolytes and Osmotic Pressure in Healthy Beagles.

Ajito

Suzuki

Iwabuchi

1999

The Journal of Veterinary Medical Science

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“…This effect of HS probably explains the improved CO after HS infusion. Because osmolality is the driving force for volume distribution, HS causes fluid shift from the intracellular space into the intravascular and interstitial spaces (30). Therefore, it increases the plasma volume more than by its own volume.…”

Section: Discussionmentioning

confidence: 99%

The Comparison of Hypertonic Saline (7.5%) and Normal Saline (0.9%) for Initial Fluid Administration Before Spinal Anesthesia

Järvelä

Honkonen²,

Järvelä³

et al. 2000

Anesthesia & Analgesia

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Hypertonic saline can be used for initial fluid administration before spinal anesthesia. It is effective in smallvolume fluid resuscitation. This randomized doubleblinded study compared the effects of 7.5% hypertonic saline (HS) and 0.9% normal saline (NS) in doses containing 2 mmol/kg of sodium in 40 ASA physical status I-II patients undergoing arthroscopy or other lower limb surgery under spinal anesthesia. We infused 1.6 mL/kg of HS or 13 mL/kg of NS for initial fluid administration before spinal anesthesia induced with a 10-mg dose of 0.5% hyperbaric bupivacaine. Etilefrine was administered to maintain mean arterial pressure at Ն80% of its control value. Systolic and diastolic blood pressure, heart rate, and cardiac index did not differ between the groups, and the amount of etilefrine administered was similar in the treatment groups. In all our patients, the plasma sodium concentrations were within the normal range after surgery and serum osmolality was within the normal range after spinal anesthesia. The time and the volume of the first micturition were similar in both groups, despite the much smaller amount of infused free water in the HS group. We conclude that 7.5% HS was as good as NS for the initial fluid administration before spinal anesthesia when the amount of sodium was kept unchanged.

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“…Several mechanisms concerning the beneficial effects of HSS administration have been proposed; one is the expansion of circulating blood volume [2,3,9,12,18]. HSS draws water from interstitial or intracellular fluid compartments, increasing plasma volume, and consequently improves the perfusion of peripheral tissues.…”

Section: Discussionmentioning

confidence: 99%

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

Suzuki

Ajito

Iwabuchi

1998

The Journal of Veterinary Medical Science

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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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Dynamic fluid redistribution in hyperosmotic resuscitation of hypovolemic hemorrhage

Cited by 129 publications

References 0 publications

Effect of Intravenous Infusion of a 7.2% Hypertonic Saline Solution on Serum Electrolytes and Osmotic Pressure in Healthy Beagles.

Effect of Intravenous Infusion of a 7.2% Hypertonic Saline Solution on Serum Electrolytes and Osmotic Pressure in Healthy Beagles.

The Comparison of Hypertonic Saline (7.5%) and Normal Saline (0.9%) for Initial Fluid Administration Before Spinal Anesthesia

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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