Respiratory, renal, hematologic, and serum biochemical effects of hypertonic saline solution in endotoxemic calves

Abstract

Summary The respiratory, renal, hematologic, and serum biochemical effects of hypertonic saline solution (hss) treatment were examined in 12 endotoxic, pentobarbitalanesthetized calves (8 to 20 days old). Escherichia coli endotoxin (055:B5) was infused iv at a rate of 0.1 μg/kg of body weight over 30 minutes. Endotoxin induced severe respiratory effects, with marked hypoxemia and increases in arterial-alveolar O2 gradient (P[A —a]O2), physiologic shunt fraction (Qs/Qt), and physiologic dead space to tidal volume ratio (Vd/Vt). Oxygen consumption was decreased, despite an increase in the systemic O2 extraction ratio. Peak effects were observed at the end of endotoxin infusion. The renal response to endotoxemia was characterized by a decrease in free-water reabsorption and osmotic clearance, as well as a decrease in sodium and phosphorus excretion. Endotoxemia induced leukopenia, thrombocytopenia, hyperphosphatemia, hypoglycemia, acidemia, and increased serum alkaline phosphatase concentrations. Calves were treated with hss (2,400 mosm/L of NaCl, 4 ml/kg, n = 4) or an equivalent sodium load of isotonic saline solution (iss; 300 mosm/L of NaCl, 32 ml/kg, n = 4) 90 minutes after the end of endotoxin administration. Both solutions were infused over a 4- to 6-minute period. A control group (n = 4> was not treated. Infusion of hss or iss failed to induce a significant change in Pao2, P(A-a)o2, (Qs/Qt), (Vd/Vt), or oxygen consumption. Both solutions increased systemic oxygen delivery to above preendotoxin values. Hypertonic saline infusion induced significant (P < 0.05) increases in serum Na and Cl concentrations and osmolality, whereas iss induced a significant increase in serum Cl concentration and a significant decrease in serum phosphorus concentration. Both hss and iss reversed the endotoxin-induced changes in renal function, with increases in free water reabsorption and osmotic clearance, as well as increases in sodium and phosphorus excretion. Sodium retention was greater following hss administration. On the basis of these findings, hypertonic saline solutions can be rapidly and safely administered to endotoxic calves.