临床综述：脓毒症中的高渗盐水复苏
Clinical review: Hypertonic saline resuscitation in sepsis.
作者信息
Oliveira Roselaine P, Velasco Irineu, Soriano Francisco Garcia, Friedman Gilberto
机构信息
Department of Critical Care Medicine, Santa Casa Hospital, Federal University of Rio Grande do Sul, Porto Alegra, Brazil.
出版信息
Crit Care. 2002 Oct;6(5):418-23. doi: 10.1186/cc1541. Epub 2002 Aug 6.
Abstract
The present review discusses the hemodynamic effects of hypertonic saline in experimental shock and in patients with sepsis. We comment on the mechanisms of action of hypertonic saline, calling upon data in hemorrhagic and septic shock. Specific actions of hypertonic saline in severe sepsis and septic shock are highlighted. Data are available that support potential benefits of hypertonic saline infusion in various aspects of the pathophysiology of sepsis, including tissue hypoperfusion, decreased oxygen consumption, endothelial dysfunction, cardiac depression, and the presence of a broad array of proinflammatory cytokines and various oxidant species. The goal of research in this field is to identify reliable therapies to prevent ischemia and inflammation, and to reduce mortality.
摘要
本综述讨论了高渗盐水在实验性休克和脓毒症患者中的血流动力学效应。我们依据出血性休克和脓毒性休克的数据，对高渗盐水的作用机制进行了评论。重点介绍了高渗盐水在严重脓毒症和脓毒性休克中的具体作用。现有数据支持高渗盐水输注在脓毒症病理生理学的各个方面可能带来的益处，包括组织灌注不足、氧消耗减少、内皮功能障碍、心脏抑制以及存在多种促炎细胞因子和各种氧化物质。该领域的研究目标是确定可靠的疗法，以预防缺血和炎症，并降低死亡率。
相似文献
1
Clinical review: Hypertonic saline resuscitation in sepsis.临床综述：脓毒症中的高渗盐水复苏
Crit Care. 2002 Oct;6(5):418-23. doi: 10.1186/cc1541. Epub 2002 Aug 6.
2
Sepsis volume reposition with hypertonic saline solution.用高渗盐溶液进行脓毒症容量复苏。
Rev Bras Ter Intensiva. 2008 Sep;20(3):267-77.
3
4
Resuscitation from hemorrhagic shock: experimental model comparing normal saline, dextran, and hypertonic saline solutions.失血性休克复苏：比较生理盐水、右旋糖酐和高渗盐溶液的实验模型
Crit Care Med. 2003 Jul;31(7):1915-22. doi: 10.1097/01.CCM.0000074725.62991.42.
5
Effects of hypertonic saline versus lactated Ringer's solution on cerebral oxygen transport during resuscitation from hemorrhagic shock.高渗盐水与乳酸林格氏液对失血性休克复苏期间脑氧输送的影响。
J Neurosurg. 1986 Apr;64(4):627-32. doi: 10.3171/jns.1986.64.4.0627.
6
Hypertonic saline resuscitation in sepsis.脓毒症中的高渗盐水复苏
Crit Care. 2002 Oct;6(5):397-8. doi: 10.1186/cc1546. Epub 2002 Aug 21.
7
Effects on intracranial pressure of resuscitation from hemorrhagic shock with hypertonic saline versus lactated Ringer's solution.高渗盐水与乳酸林格氏液用于失血性休克复苏对颅内压的影响
Crit Care Med. 1985 May;13(5):407-11. doi: 10.1097/00003246-198505000-00008.
8
Intraosseous resuscitation of hemorrhagic shock in a pediatric animal model using a low sodium hypertonic fluid.在儿科动物模型中使用低钠高渗液进行失血性休克的骨内复苏。
Crit Care Med. 1996 Jun;24(6):1054-61. doi: 10.1097/00003246-199606000-00028.
9
Effects of different types of fluid resuscitation for hemorrhagic shock on splanchnic organ microcirculation and renal reactive oxygen species formation.不同类型液体复苏对失血性休克患者内脏器官微循环及肾脏活性氧生成的影响
Crit Care. 2015 Dec 11;19:434. doi: 10.1186/s13054-015-1135-y.
10
Effect of hypertonic saline/dextran on post-stenotic myocardial perfusion, metabolism, and function during resuscitation from hemorrhagic shock in anesthetized pigs.高渗盐水/右旋糖酐对麻醉猪失血性休克复苏过程中狭窄后心肌灌注、代谢及功能的影响。
Shock. 1997 Feb;7(2):119-30. doi: 10.1097/00024382-199702000-00008.
引用本文的文献
1
Reviving the Critically Ill: Exploring Effective Fluid Resuscitation Approaches for Diverse Hypovolemic Shock Cases-A Systematic Review and Meta-Analysis.挽救重症患者：探索针对不同类型低血容量性休克病例的有效液体复苏方法——一项系统综述与荟萃分析
Bull Emerg Trauma. 2024;12(4):149-161. doi: 10.30476/beat.2024.102206.1505.
2
Hypertonic Saline Induces Host Protective Immune Responses against Infection in Mice.高渗盐水诱导宿主对 感染产生保护性免疫应答。
J Microbiol Biotechnol. 2024 Nov 28;34(11):2192-2200. doi: 10.4014/jmb.2407.07040. Epub 2024 Sep 11.
3
European Society of Intensive Care Medicine clinical practice guideline on fluid therapy in adult critically ill patients. Part 1: the choice of resuscitation fluids.欧洲重症监护医学学会成人危重症患者液体治疗临床实践指南。第 1 部分：复苏液的选择。
Intensive Care Med. 2024 Jun;50(6):813-831. doi: 10.1007/s00134-024-07369-9. Epub 2024 May 21.
4
Intravenous fluid therapy in sepsis.脓毒症的静脉补液治疗。
Nutr Clin Pract. 2022 Oct;37(5):990-1003. doi: 10.1002/ncp.10892. Epub 2022 Jul 8.
5
Hypertonic Saline in the Treatment of Hemorrhagic Shock.高渗盐水治疗失血性休克
Adv J Emerg Med. 2017 Oct 13;1(1):e8. doi: 10.22114/AJEM.v1i1.2. eCollection 2017 Fall.
6
Resuscitation fluids.复苏液。
Curr Opin Crit Care. 2018 Dec;24(6):512-518. doi: 10.1097/MCC.0000000000000551.
7
The influence of acute elevations in plasma osmolality and serum sodium on sympathetic outflow and blood pressure responses to exercise.血浆渗透压和血清钠急性升高对运动时交感神经输出及血压反应的影响。
J Neurophysiol. 2018 Apr 1;119(4):1257-1265. doi: 10.1152/jn.00559.2017. Epub 2017 Dec 13.
8
Cardiac output changes after osmotic therapy in neurosurgical and neurocritical care patients: a systematic review of the clinical literature.神经外科和神经危重症患者渗透性治疗后的心输出量变化：临床文献的系统评价。
Br J Clin Pharmacol. 2018 Apr;84(4):636-648. doi: 10.1111/bcp.13492. Epub 2018 Jan 18.
9
Pretreatment with endothelium-derived nitric oxide synthesis modulators on gastrointestinal microcirculation during NOTES: an experimental study.NOTES期间内皮源性一氧化氮合成调节剂对胃肠道微循环的预处理：一项实验研究
Surg Endosc. 2016 Dec;30(12):5232-5238. doi: 10.1007/s00464-016-4870-5. Epub 2016 Mar 23.
10
Choice of Fluid Therapy in the Initial Management of Sepsis, Severe Sepsis, and Septic Shock.脓毒症、严重脓毒症及脓毒性休克初始治疗中的液体疗法选择
Shock. 2016 Jul;46(1):17-26. doi: 10.1097/SHK.0000000000000577.
本文引用的文献
1
Early goal-directed therapy in the treatment of severe sepsis and septic shock.早期目标导向治疗在严重脓毒症和脓毒性休克治疗中的应用
N Engl J Med. 2001 Nov 8;345(19):1368-77. doi: 10.1056/NEJMoa010307.
2
Hypertonic saline activation of p38 MAPK primes the PMN respiratory burst.高渗盐水激活p38丝裂原活化蛋白激酶引发中性粒细胞呼吸爆发。
Shock. 2001 Oct;16(4):285-9. doi: 10.1097/00024382-200116040-00009.
3
Hypertonicity rescues T cells from suppression by trauma-induced anti-inflammatory mediators.高渗状态可使T细胞免受创伤诱导的抗炎介质的抑制作用。
Am J Physiol Cell Physiol. 2001 Sep;281(3):C840-8. doi: 10.1152/ajpcell.2001.281.3.C840.
4
Effects of hypertonic saline on expression of human polymorphonuclear leukocyte adhesion molecules.高渗盐水对人多形核白细胞黏附分子表达的影响。
J Leukoc Biol. 2001 Aug;70(2):261-73.
5
Synergistic induction of IL-10 by hypertonic saline solution and lipopolysaccharides in murine peritoneal macrophages.高渗盐溶液和脂多糖对小鼠腹腔巨噬细胞白细胞介素-10的协同诱导作用
Surgery. 2001 Aug;130(2):157-65. doi: 10.1067/msy.2001.115829.
6
Hypertonic saline alteration of the PMN cytoskeleton: implications for signal transduction and the cytotoxic response.高渗盐水对中性粒细胞细胞骨架的改变：对信号转导和细胞毒性反应的影响。
J Trauma. 2001 Feb;50(2):206-12. doi: 10.1097/00005373-200102000-00004.
7
Hypertonic saline infusion: can it regulate human neutrophil function?高渗盐水输注：它能调节人类中性粒细胞功能吗？
Shock. 2000 Nov;14(5):503-8.
8
Novel strategies for immunomodulation after trauma: revisiting hypertonic saline as a resuscitation strategy for hemorrhagic shock.创伤后免疫调节的新策略：重新审视高渗盐水作为失血性休克复苏策略。
J Trauma. 2000 Oct;49(4):580-3. doi: 10.1097/00005373-200010000-00002.
9
In vivo and in vitro modulation of intercellular adhesion molecule (ICAM)-1 expression by hypertonicity.高渗对细胞间黏附分子（ICAM）-1表达的体内和体外调节
Shock. 2000 Sep;14(3):409-14; discussion 414-5. doi: 10.1097/00024382-200014030-00029.
10
Hypertonic saline inhibits neutrophil (PMN) priming via attenuation of p38 MAPK signaling.高渗盐水通过减弱p38丝裂原活化蛋白激酶信号传导来抑制中性粒细胞（PMN）的预激活。
Shock. 2000 Sep;14(3):265-9; discussion 269-70. doi: 10.1097/00024382-200014030-00004.
Zotero 插件