Hypertonic saline improves myocardial blood flow during CPR, but is not enhanced further by the addition of hydroxy ethyl starch

Part 8: Adult Advanced Cardiovascular Life Support

“…Most human and animal studies of fluid infusion during CPR did not have a control group, [332][333][334][335][336][337][338][339][340][341][342][343] and 2 animal studies showed that normothermic fluid infusion during CPR caused a decrease in CPP. 344 -346 In addition to normothermic fluid, hypertonic and chilled fluids have been studied in animal and small human studies without a survival benefit.…”

Post–Cardiac Arrest Syndrome

“…No evidence is available to indicate an advantage for any specific type of fluid (crystalloid or colloid) in the post-cardiac arrest phase. Some animal data are available indicating that hypertonic saline may improve myocardial and cerebral blood flow when given during CPR, 137,138 but no clinical data indicate an advantage for hypertonic saline in the post-cardiac arrest phase. The balance between systemic oxygen delivery and consumption can be monitored indirectly with mixed venous oxygen saturation (SvO 2 ) or ScvO 2 .…”

Methylene blue added to a hypertonic–hyperoncotic solution increases short-term survival in experimental cardiac arrest*

“…A similar model has been employed to assess the efficacy of hypertonic-hyperoncotic solutions, which have been demonstrated to improve myocardial blood flow during CPR (11) and by acting as a cardioprotective and neuroprotective agent in the reperfusion period (12,13). Thus, one trial group received a combination of hypertonic saline with dextran and MB, and a second group received hypertonic saline with dextran only.…”