A Clinical Approach to Antioxidant Therapy: Hypertonic Fluid Resuscitation Trial
DEFENCE RESEARCH AND DEVELOPMENT TORONTO (CANADA)
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It is well established that severe trauma with hemorrhagic shock produces significant immunomoduation, including enhanced PMN activation, adherence and emigration into tissues, along with the induction of inflammatory cytokine cascades, which collectively contribute to the systemic inflammatory response syndrome SIRS, frequently culminating in acute respiratory distress syndrome ARDS and multiple organ dysfunction syndrome MODS. The hemodynamic and physiological benefits of hypertonic saline dextran solutions HSD have been evaluated extensively in animal and human research, and efficacy has been suggested for the treatment of hemorrhagic shock. Work from our research group and others has substantiated that in comparison to large volume crystalloid resuscitation, small volume resuscitation with HSD has the remarkable capacity to reduce potentially deleterious immunologic complications. However, human clinical studies evaluating the cellular and molecular immune consequences of small-volume HSD resuscitation are lacking also there is need to investigate modified fluid formulations incorporating novel antiinflammatory agents such as the antioxidant N-acetylcysteine.
- Medicine and Medical Research