Effect of Hypertonic Saline Pre-treatment on Ischemia–Reperfusion Lung Injury in Pig

Roch, Antoine; Castanier, Matthias; Mardelle, V.; Trousse, Delphine; Marin, Valérie; Avaro, J.-P.; Taséi, Anne-Marie; Blayac, D.; Michelet, Pierre; Fusaı̈, Thierry; Papazian, Laurent

doi:10.1016/j.healun.2008.07.004

Cited by 16 publications

(10 citation statements)

References 35 publications

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“…13,32 Finally, hypertonic solutions also have been reported to worsen lung injury not by affecting HPV or cardiac output but probably by a direct deleterious effect of hyperosmolarity on endothelial permeability. 34 In the current study, as could be expected in pigs with uninjured lungs, hemodilution with HS-HES did not deteriorate arterial oxygenation despite the HPV attenuation.…”

Section: Hemodilution With Hs-hessupporting

confidence: 76%

“…33 In a more recent study by the same group, hypertonic saline worsened ischemia and reperfusion lung injury. 34 According to the clinical condition or experimental model, hypertonic saline solutions can thus improve and not affect or worsen pulmonary gas exchange. Such discrepancies are easily explained by the absence or presence of lung injury.…”

Section: Hemodilution With Hs-hesmentioning

confidence: 99%

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Hypertonic Saline Hydroxyethylstarch Restores Right Ventricular-Arterial Coupling after Normovolemic Hemodilution in Piglets

et al. 2011

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Background: Normovolemic hemodilution is known to inhibit hypoxic pulmonary vasoconstriction. How the coupling between the pulmonary arterial (PA) circulation and the right ventricle (RV) is affected by normovolemic hemodilution and by the composition of replacement solutions remains unknown. Therefore, the effects of isotonic and hypertonic saline hydroxyethylstarch solutions on the pulmonary circulation and RV, in control and hypoxic conditions, were compared. Methods: Anesthetized piglets (n ϭ 14) were equipped with manometer-tipped catheters in the RV and main PA and an ultrasonic flow probe around the main PA. The pulmonary circulation was assessed by pressure-flow relations and vascular impedance, RV afterload by effective arterial elastance (Ea), RV contractility by end-systolic elastance (Ees), and RV-PA coupling by the Ees/Ea ratio. Measurements were done in control (FIO 2 0.40) and hypoxic (FIO 2 0.12) conditions before and after acute normovolemic hemodilution with either 20 ml/kg isotonic saline hydroxyethylstarch (hy-

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Section: Hemodilution With Hs-hessupporting

confidence: 76%

Section: Hemodilution With Hs-hesmentioning

confidence: 99%

Hypertonic Saline Hydroxyethylstarch Restores Right Ventricular-Arterial Coupling after Normovolemic Hemodilution in Piglets

et al. 2011

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“…Thus it has been shown that IL-6 triggers production of metalloproteinase inhibitors, such as alpha 2-macroglobulin by perivascular astrocytes [17], resulting in BBB failure and perivascular cerebral edema. Also elevated circulating levels of IL-6 have been reported to enhance pulmonary permeability and endothelial damage in different conditions, such as ischemia-perfusion during lung transplantation [18], pulmonary exposure to diesel [19], or intestinal ischemia [20]. Moreover other proinflammatory cytokines, such as TNF-α, IL-1β and IFN-γ (Interferon-γ) have been shown to increase pulmonary permeability, resulting in pulmonary edema [21].…”

Section: Methodsmentioning

confidence: 99%

Cytokine response to diabetic ketoacidosis (DKA) in children with type 1 diabetes (T1DM)

et al. 2011

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“…The use of hypertonic saline did not exert a preventive effect on the appearance of ALI and pulmonary edema after hemorrhage in this study. Those authors even observed a deleterious effect with the prior use of hypertonic saline before performing experimental ischemia-reperfusion by clamping the pulmonary arteries [43]. This effect appeared to be independent of the hemodynamic effects of saline but was more probably linked to a direct effect on alveolocapillary barrier permeability.…”

Section: Modulation Of Oncotic or Osmotic Pressure: The Effects Of Admentioning

confidence: 99%

Fluid management in acute lung injury and ards

Roch

Guervilly

Papazian

2011

Ann. Intensive Care

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ARDS is particularly characterized by pulmonary edema caused by an increase in pulmonary capillary permeability. It is considered that limiting pulmonary edema or accelerating its resorption through the modulation of fluid intake or oncotic pressure could be beneficial. This review discusses the principal clinical studies that have made it possible to progress in the optimization of the fluid state during ARDS. Notably, a randomized, multicenter study has suggested that fluid management with the goal to obtain zero fluid balance in ARDS patients without shock or renal failure significantly increases the number of days without mechanical ventilation. On the other hand, it is accepted that patients with hemodynamic failure must undergo early and adapted vascular filling. Liberal and conservative filling strategies are therefore complementary and should ideally follow each other in time in the same patient whose hemodynamic state progressively stabilizes. At present, although albumin treatment has been suggested to improve oxygenation transiently in ARDS patients, no sufficient evidence justifies its use to mitigate pulmonary edema and reduce respiratory morbidity. Finally, the resorption of alveolar edema occurs through an active mechanism, which can be pharmacologically upregluated. In this sense, the use of beta-2 agonists may be beneficial but further studies are needed to confirm preliminary promising results.

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Effect of Hypertonic Saline Pre-treatment on Ischemia–Reperfusion Lung Injury in Pig

Cited by 16 publications

References 35 publications

Hypertonic Saline Hydroxyethylstarch Restores Right Ventricular-Arterial Coupling after Normovolemic Hemodilution in Piglets

Hypertonic Saline Hydroxyethylstarch Restores Right Ventricular-Arterial Coupling after Normovolemic Hemodilution in Piglets

Cytokine response to diabetic ketoacidosis (DKA) in children with type 1 diabetes (T1DM)

Fluid management in acute lung injury and ards

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