| Effect of 7.2% hypertonic saline/6% hetastarch on left ventricular contractility in anesthetized humans. | |
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MedLine Citation:
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PMID: 7540812 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although a positive inotropic effect of hypertonic saline has been demonstrated in isolated cardiac tissue as well as in animal preparations, no information exists about a possible positive inotropic action of hypertonic saline in humans. The aim of this investigation was to determine whether a clinically relevant positive inotropic effect can be demonstrated in humans. METHODS: Twenty-six patients without cardiovascular disease were randomized to receive 4 ml/kg of either 7.2% hypertonic saline/6% hetastarch or 6% hetastarch (control) at a rate of 1 ml.kg-1.min-1 while under general endotracheal anesthesia. Transesophageal echocardiography was used to evaluate left ventricular function. Arterial pressure, heart rate, and left ventricular end-systolic and end-diastolic diameter, area, and wall thickness were measured immediately before and after administration of either solution. Fractional area change, end-systolic wall stress, and the area under the end-systolic pressure-length relationship curve (ESPLRarea) were calculated. ESPLRarea was used to assess left ventricular contractility. RESULTS: Administration of hypertonic saline/hetastarch resulted in a significant decrease of mean arterial pressure and end-systolic wall stress from 77 +/- 14 (mean +/- SD) to 64 +/- 17 mmHg (P < 0.01) and from 52 +/- 14 to 32 +/- 11 10(3) dyne/cm2 (P > 0.01), respectively. End-diastolic area and fractional area change increased from 16.5 +/- 2.9 to 21.7 +/- 3.3 cm2 (P < 0.01) and from 0.53 +/- 0.07 to 0.70 +/- 0.06 (P < 0.01), respectively, whereas there was only a minor change of ESPLRarea from 38 +/- 13 to 44 +/- 13 mmHg.cm (P < 0.05). CONCLUSIONS: The apparent improvement of left ventricular systolic function in response to hypertonic saline/hetastarch is caused mainly by the combined effect of increased left ventricular preload and reduced left ventricular afterload. A possible positive inotropic action of hypertonic saline/hetastarch is not likely to be clinically relevant. |
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Authors:
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A W Goertz; T Mehl; K H Lindner; M G Rockemann; U Schirmer; B Schwilk; M Georgieff |
Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Anesthesiology Volume: 82 ISSN: 0003-3022 ISO Abbreviation: Anesthesiology Publication Date: 1995 Jun |
Date Detail:
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Created Date: 1995-07-21 Completed Date: 1995-07-21 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1389-95 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, University of Ulm, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anesthesia, General* Female Hetastarch / pharmacology Humans Male Middle Aged Myocardial Contraction / drug effects* Saline Solution, Hypertonic / pharmacology* Ventricular Function, Left / drug effects* |
| Chemical | |
Reg. No./Substance:
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0/Saline Solution, Hypertonic; 9005-27-0/Hetastarch |
| Comments/Corrections | |
Comment In:
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Anesthesiology. 1996 Feb;84(2):474-5
[PMID:
8602686
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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