Resuscitation using HTS provides a transient but remarkable recovery of cardiovascular function. During the recovery, blood pressure, cardiac output, and organ blood flow rapidly increase because of an osmotic redistribution of fluid into the intravascular compartment. The term 'small-volume resuscitation' is used since hypertonic solutions provide equal circulatory improvement at less than one fifth the volume of the conventional crystalloids. In addition to its promising role as an initial resuscitative fluid in both the prehospital setting and the emergency room, small-volume resuscitation using HTS offers certain advantages in resuscitation at the battlefield situation or the clinical management of mass casualty patients. Hypertonic solutions are efficacious, inexpensive, readily available, and have long shelf lives, which make them attractive resuscitative fluids, particularly when large-volume resuscitation is unavailable or contraindicated. Hypertonic saline also reduces bacterial translocation, suggesting that it may be beneficial in critically ill patients who are at risk of developing multiple organ failure. Importantly, HTS has been shown to restore immune function and provide protecton from sepsis in an animal model. These recent data provide a plausible explanation for the reduction in the incidences of adult respiratory distress syndrome and sepsis in patients resuscitated with HTS. Future clinical studies are warranted to examine the role of HTS in the restoration of immune function.
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine