| Hypertonic saline and dextran: impact on cardiac function in the isolated rat heart. | |
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MedLine Citation:
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PMID: 1693695 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Hypertonic saline with dextran (HSD) has been recently introduced for prehospital resuscitation of hemorrhagic shock, and is currently undergoing clinical investigation. To determine the effect of clinically relevant amounts of hypertonic saline (7.5% NaCl) and/or 6% dextran 70 on non-ischemic and post-ischemic hearts, we infused rat hearts (Langendorff, 20 minutes global ischemia, 37 degrees, 40 minutes' reperfusion) with: 1) 0.9% NaCl (control); 2) 7.5% NaCl/dextran; 3) 7.5% NaCl; or 4) dextran. We found that 7.5% NaCl alone or with dextran depressed ventricular function (developed pressure, DP; contractility, +dP/dt; and relaxation rate, -dP/dt) in non-ischemic hearts. In contrast, equimolar (2,400 mOsm) sucrose increased myocardial contractility (+dP/dt) of non-ischemic hearts. Coronary flow was unchanged by the addition of 7.5% NaCl, dextran, or sucrose. Treatment of ischemic hearts with 7.5% NaCl/dextran, dextran alone, or sucrose improved recovery of ventricular function compared to 0.9% or 7.5% NaCl. Furthermore, dextran (but not sucrose) with or without 7.5% NaCl reduced myocardial hydrogen peroxide (H2O2) levels during ischemia and reperfusion. We conclude that when given in clinically relevant amounts in the isolated rat heart: 1) 7.5% NaCl directly depresses myocardial function; 2) 7.5% NaCl alone does not improve post-ischemic ventricular function; 3) 7.5% NaCl with dextran or dextran alone improves post-ischemic ventricular function in part by reducing myocardial H2O2; and 4) sucrose equimolar to 7.5% HSD increases ventricular function in non-ischemic and post-ischemic hearts. This investigation suggests that the post-shock benefit of HSD is unrelated to direct myocardial effects of saline but is due in part to toxic oxygen metabolite scavenging by dextran. |
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Authors:
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J M Brown; M A Grosso; E E Moore |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of trauma Volume: 30 ISSN: 0022-5282 ISO Abbreviation: J Trauma Publication Date: 1990 Jun |
Date Detail:
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Created Date: 1990-07-19 Completed Date: 1990-07-19 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376373 Medline TA: J Trauma Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 646-50; discussion 650-1 Citation Subset: AIM; IM |
Affiliation:
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Department of Surgery, Denver General Hospital, Colorado. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Coronary Circulation Depression, Chemical Dextrans / pharmacology* Heart / drug effects* Hydrogen Peroxide / analysis Ischemia / physiopathology Male Myocardial Reperfusion Myocardium / analysis Rats Rats, Inbred Strains Saline Solution, Hypertonic / pharmacology* Sucrose / pharmacology |
| Chemical | |
Reg. No./Substance:
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0/Saline Solution, Hypertonic; 57-50-1/Sucrose; 7722-84-1/Hydrogen Peroxide; 9004-54-0/Dextrans |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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