New and Future Resuscitation Fluids for Trauma Patients Using Hemoglobin and Hypertonic Saline

2013 ◽  
Vol 31 (1) ◽  
pp. 1-19 ◽  
Author(s):  
Samuel M. Galvagno ◽  
Colin F. Mackenzie
Keyword(s):  
Hypertonic Saline ◽  
Trauma Patients

scholarly journals Plasma dextran concentrations in trauma patients administered hypertonic saline-dextran-70

1996 ◽  
Vol 42 (5) ◽  
pp. 779-780 ◽  
Author(s):  
C E Wade ◽  
M A Dubick ◽  
M J Vassar ◽  
C A Perry ◽  
J W Holcroft
Keyword(s):  
Hypertonic Saline ◽  
Trauma Patients ◽  
Dextran 70

Hypertonic saline enhances neutrophil elastase release through activation of P2 and A3 receptors

2006 ◽  
Vol 290 (4) ◽  
pp. C1051-C1059 ◽  
Author(s):  
Yu Chen ◽  
Naoyuki Hashiguchi ◽  
Linda Yip ◽  
Wolfgang G. Junger
Keyword(s):  
Hypertonic Saline ◽  
Tissue Damage ◽  
Cell Activation ◽  
Atp Release ◽  
Clinical Effectiveness ◽  
Polymorphonuclear Neutrophil ◽  
Trauma Patients ◽  
Pharmacological Targets ◽  
Formyl Peptide ◽  
Resuscitation Fluid

Hypertonic saline (HS) holds promise as a novel resuscitation fluid for the treatment of trauma patients because HS inhibits polymorphonuclear neutrophil (PMN) activation and thereby prevents host tissue damage and associated posttraumatic complications. However, depending on conditions of cell activation, HS can increase PMN degranulation, which could exacerbate tissue damage in trauma victims. The cellular mechanism by which HS increases degranulation is unknown. In the present study, we tested whether HS-induced ATP release from PMN and feedback via P1 and/or P2 receptors may be involved in the enhancement of degranulation by HS. We found that HS enhances elastase release and ERK and p38 MAPK activation when HS is added after activation of PMN with formyl peptide (fMLP) or phorbol ester (PMA). Agonists of P2 nucleotide and A3 adenosine receptors mimicked these enhancing effects of HS, whereas antagonists of A3 receptors or removal of extracellular ATP with apyrase diminished the response to HS. A1 adenosine receptor antagonists increased the enhancing effect of HS, whereas A1 receptor agonists inhibited elastase release. These data suggest that HS upregulates degranulation via ATP release and positive feedback through P2 and A3 receptors. We propose that these feedback mechanisms can serve as potential pharmacological targets to fine-tune the clinical effectiveness of HS resuscitation.

scholarly journals Responsiveness to different volume therapies following hemodilution and hemorrhagic shock: a comparative experimental study in rats

2007 ◽  
Vol 22 (5) ◽  
pp. 355-360 ◽  
Author(s):  
Riad Naim Younes ◽  
Fernanda Deutsch ◽  
Mario Itinoshe ◽  
Belchor Fontes ◽  
Renato Poggetti ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Hemorrhagic Shock ◽  
Hypertonic Saline ◽  
Hypovolemic Shock ◽  
Isotonic Saline ◽  
High Volume ◽  
Subsequent Treatment ◽  
Volume Replacement ◽  
Trauma Patients

Guidelines for volume replacement for acutely hemorrhaged and hemodiluted trauma patients have not been well established. Purpose: To evaluate the effects of acute hemodilution on mean arterial pressure (MAP), and responsiveness of acutely hemodiluted and subsequently hemorrhaged rats to different volume therapies. Methods: 180 rats were hemodiluted to simulate hemorrhaged trauma patients with persistent bleeding after high volume replacement with isotonic solutions. Thirty hemodiluted [Anemia (ANE) group] animals received no further treatment. The remaining 150 animals were subjected to hypovolemic shock and randomized into five groups, according to the treatment option employed: Control (CTL) animals did not receive subsequent treatment after hemorrhagic hypovolemia, SAL4 animals received isotonic saline 4 mL/kg, SAL32 animals received isotonic saline 32 mL/kg, HS animals received hypertonic saline 4 mL/kg and BLD animals received re-infusion of drawn blood. Results: Highest mean arterial pressure (MAP) was achieved by BLD, followed by SAL32 and HS. MAP after treatment of BLD, HS, SAL32 and ANE were higher than CTL (p=0.036). At 85 and 95 minutes of experiment, SAL4, SAL32 and HS presented the lowest hematocrit levels (p<0.01). At day 3, ANE, CTL and HS had the highest hematocrit. SAL4 and CTL groups presented the highest mortality rates. Conclusion: Hypertonic saline is an effective and safe initial therapy for hemodiluted rats undergoing hemorrhagic shock, with an overall outcome comparable to blood replacement or high volume isotonic saline administration.

scholarly journals The effectiveness of prehospital hypertonic saline for hypotensive trauma patients: a systematic review and meta-analysis

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
I. E. Blanchard ◽  
A. Ahmad ◽  
K. L. Tang ◽  
P. E. Ronksley ◽  
D. Lorenzetti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hypertonic Saline ◽  
Meta Analysis ◽  
Trauma Patients

Physiological and hypertonic saline solutions impair ciliary activity in vitro

2000 ◽  
Vol 25 (4) ◽  
pp. 331-332
Author(s):  
W.M. Boek ◽  
N. Keles ◽  
K. Graamans ◽  
E.H. Huizing
Keyword(s):  
Hypertonic Saline ◽  
Ciliary Activity ◽  
Saline Solutions

Hypertonic saline in traumatic brain injury: Current status

2004 ◽  
Vol 1 (2) ◽  
pp. 15-20 ◽  
Author(s):  
Kavita Sandhu ◽  
TVSP Murthy ◽  
Brig T Prabhakar
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hypertonic Saline ◽  
Current Status
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