Agradecemos la colaboración en la discusión, al  Prof. Alfredo Rovere que  realizó investigación en animales sobre este tema y  al Prof. Jaime Grin que en nuestro medio fue el primero en emplear estas soluciones en diversos tipos de shock.

Referencias:

1.       The SAFE Study Investigators. “A Comparison of Albumin and Saline for Fluid Resuscitation in the Intensive Care Unit”.  N Engl J Med 2004;350:2247-56.

2.       Kellum y col. Saline-induced hyperchloremic metabolic acidosis. Crit Care Med 2002, 30: 259-261.

3.       Nicholas J. Wilkes, Rex Woolf, Marjorie Mutch, Susan V. Mallett, Tim Peachey, Robert Stephens, and Michael G. Mythen. The Effects of Balanced Versus Saline-Based Hetastarch and Crystalloid Solutions on Acid-Base and Electrolyte Status and Gastric Mucosal Perfusion in Elderly Surgical Patients. Anesth. Analg. 2001 93: 811-816. 

4.       M. Raghavan, H. Murray, J A Kellum. Year Book of Intensive Care and Emergency Medicine 2006, Ed J L Vincent, pág. 69.

5.       Pedoto y Col. Acidosis stimulates nitric oxide production and lung damage in rats. American journal of respiratory and Crit Care Med 1999,159: 397- 402

6.       Kellum y col. Fluid resuscitation and hyperchloremic acidosis in experimental sepsis: Improved short-term survival and acid-base balance with Hextend compared with saline. Crit Care Med 2002, 30: 300- 305.

7.       M. Raghavan, H. Murray, J A Kellum. Year Book of Intensive Care and Emergency Medicine 2006, Ed J L Vincent, pág. 70.

8.       Mauricio Rocha-e-Silva and Luiz F. Poli de Figueiredo. Small volume hypertonic resuscitation of circulatory shock. Clinics 60(2):159-172, 2005.

9.       Younes RN, Aun F, Accioly CQ, Casale LP, Szajnbok I, Birolini D. Department of Surgery, University of Sao Paulo School of Medicine, Brazil. Hypertonic solutions in the treatment of hypovolemic shock: a prospective, randomized study in patients admitted to the emergency room. Surgery. 1992 Apr;111(4):380-5.

10.    Chiara O, Pelosi P, Brazzi L, Bottino N, Taccone P, Cimbanassi S, Segala M, Gattinoni L, Scalea T. Dipartimento Scienze Chirurgiche, Universita' delgi Studi di Milano, IRCCS Ospedale Maggiore, Italy. Resuscitation from hemorrhagic shock: experimental model comparing normal saline, dextran, and hypertonic saline solutions. Crit Care Med. 2003 Jul;31(7):1915-22.

11.    Poli-de-Figueiredo LF, Cruz RJ Jr, Sannomiya P, Rocha-E-Silva M. Department of Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil. Mechanisms of action of hypertonic saline resuscitation in severe sepsis and septic shock. Endocr Metab Immune Disord Drug Targets. 2006 Jun;6(2):201-6

12.    Wade CE. Department of Neurobiology, Physiology and Behavior, University of California at Davis, Davis, California, USA. Hypertonic saline resuscitation in sepsis. Crit Care. 2002 Oct;6(5):397-8. Epub 2002 Aug 21. Comment on: Crit Care. 2002 Oct;6(5):418-23.

13.    Rocha-e-Silva M, Poli de Figueiredo LF. Heart Institute, Hospital das Clinicas, Faculty of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil. Small volume hypertonic resuscitation of circulatory shock. Clinics. 2005 Apr;60(2):159-72. Epub 2005 Apr 26.

14.    Rocha e Silva M. Research Division, Faculty of Medicine, University of Sao Paulo, Brazil. Hypertonic saline resuscitation. Medicina (B Aires). 1998;58(4):393-402.

15.    Pascual JL, Khwaja KA, Chaudhury P, Christou NV. Division of General Surgery, McGill University Health Center, Montreal, Quebec, Canada. Hypertonic saline and the microcirculation. J Trauma. 2003 May;54(5 Suppl):S133-40.

16.    Powers KA, Zurawska J, Szaszi K, Khdaroo RG, Kapus A, Rotstein OD.  Hypertonic resuscitation of hemorrhagic shock prevents alveolar macrophage activation by preventing systemic oxidative stress due to gut ischemia/reperfusion. Surgery 2005 137:66-74.

17.    Rizoli SB, Kapus A, Rotstein OD. Cell volume-dependent regulation of L-selectin shedding in neutrophils. A role for p38 mitogen-activated protein kinase. J Biol Chem 1999 274:22072-22080.

18.    Rizoli SB, Kapus A, Parodo J, Fan J, Rotstein OD. Hypertonic immunomodulation is reversible and accompanied by changes in CD11b expression. J Surg Res 1999 83:130-135.

19.    Ciesla DJ, Moore EE, Gonzalez RJ, Biffl WL, Silliman CC. Hypertonic saline inhibits neutrophil (PMN) priming via attenuation of p38 MAPK signaling. Shock 2000 14:265-269.

20.    Orlic T, Loomis WH, Shreve A, Namiki S, Junger WG. Hypertonicity increases cAMP in PMN and blocks oxidative burst by PKA-dependent and independent mechanisms. Am J Physiol Cell Physiol 2002 282:c1261-c1269

21.    Staudenmayer KL, Maier RV, Jelacic S, Bulger EM. Hypertonic saline modulates innate immunity in a model of systemic inflammation. Shock 2005 23:459-463.

22.    Murao Y, Hata M, Ohnishi K, et al. Hypertonic saline resuscitation reduces apoptosis and tissue damage of the small intestine in a mouse model of hemorrhagic shock. Shock 2003 20:23-28.

23.    Somell A, Sollevi A, Suneson A, Riddez L, Hjelmqvist H. Beneficial effects of hypertonic saline/dextran on early survival in porcine endotoxin shock. Acta Anaesthesiol Scand 2005 49:1124-1134.

24.    Rizoli SB, Rhind SG, Shek PN, Inaba K, Filips D, Tien H, Brenneman F, Rotstein The immunomodulatory effects of hypertonic saline resuscitation in patients sustaining traumatic hemorrhagic shock: a randomized, controlled, double-blinded trial. Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. Ann Surg. 2006 Jan;243(1):47-57.

25.    Jean-Louis Vincent, MD, PhD, FCCM; Jacques Berré, MD. Primer on medical management of severe brain injury. Crit Care Med 2005 33(6):1392-1399.

26.    Paterna S, Di Pasquale P, Parrinello G, Amato P, Cardinale A, Follone G, Giubilato A, Licata G. Effects of high-dose furosemide and small-volume hypertonic saline solution infusion in comparison with a high dose of furosemide as a bolus, in refractory congestive heart failure. Eur J Heart Fail. 2000 Sep;2(3):305-13.

27.    Younes RN et al. - Hypertonic/hyperoncotic solution in hypovolemic patients: experience in the emergency room. Rev. Hosp. Clín. Fac. Med. S. Paulo 57(3): 2002.

28.    Lopes OU, Pontieri V, Rocha e Silva M Jr, Velasco IT. Hyperosmotic NaCl and severe hemorrhagic shock: role of the innervated lung. Am J Physiol. 1981 Dec;241(6):H883-90.

29.    Rocha e Silva M. Hypertonic saline resuscitation. Medicina (B Aires) 1998;58(4):393-402.

30.    de Felippe J Jr, Timoner J, Velasco IT, Lopes OU, Rocha-e-Silva M Jr. Treatment of refractory hypovolaemic shock by 7.5% sodium chloride injections. Lancet. 1980 Nov 8;2(8202):1002-4. 

31.    Schimetta W, Schöchl H, Kröll W, Pölz W, Pölz G, Mauritz W. Safety of hypertonic hyperoncotic solutions--a survey from Austria. Wien Klin Wochenschr. 2002 Feb 15;114(3):89-95.

32.    Bruscagin V, de Figueiredo LF, Rasslan S, Varicoda EY, Rocha e Silva M.  Fluid resuscitation improves hemodynamics without increased bleeding in a model of uncontrolled hemorrhage induced by an iliac artery tear in dogs. J Trauma. 2002 Jun;52(6):1147-52.