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Immunomodulatory effect of hypertonic saline in hemorrhagic shock.
| Content Provider | Europe PMC |
|---|---|
| Author | Motaharinia, Javad Etezadi, Farhad Moghaddas, Azadeh Mojtahedzadeh, Mojtaba |
| Abstract | Multiple organ dysfunction syndrome (MODS) and nosocomial infection following trauma-hemorrhage are among the most important causes of mortality in hemorrhagic shock patients. Dysregulation of the immune system plays a central role in MODS and a fluid having an immunomodulatory effect could be advantageous in hemorrhagic shock resuscitation. Hypertonic saline (HS) is widely used as a resuscitation fluid in trauma-hemorrhagic patients. Besides having beneficial effects on the hemodynamic parameters, HS has modulatory effects on various functions of immune cells such as degranulation, adhesion molecules and cytokines expression, as well as reactive oxygen species production. This article reviews clinical evidence for decreased organ failure and mortality in hemorrhagic shock patients resuscitated with HS. Despite promising results in animal models, results from pre-hospital and emergency department administration in human studies did not show improvement in survival, organ failure, or a reduction in nosocomial infection by HS resuscitation. Further post hoc analysis showed some benefit from HS resuscitation for severely-injured patients, those who received more than ten units of blood by transfusion, patients who underwent surgery, and victims of traumatic brain injury. Several reasons are suggested to explain the differences between clinical and animal models. |
| Related Links | https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC4593217&blobtype=pdf |
| ISSN | 15608115 |
| Journal | DARU Journal of Pharmaceutical Sciences [Daru] |
| Volume Number | 23 |
| DOI | 10.1186/s40199-015-0130-9 |
| PubMed Central reference number | PMC4593217 |
| PubMed reference number | 26437974 |
| e-ISSN | 20082231 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2015-10-05 |
| Publisher Place | London |
| Access Restriction | Open |
| Rights License | Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. © Motaharinia et al. 2015 |
| Subject Keyword | Hypertonic saline Hemorrhagic shock Trauma Anti-inflammatory Multiple organ failure Acute lung injury |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine Drug Discovery Pharmacology |
