[Hypertonic saline in the treatment of hypovolemia]

Following infusion of hypertonic saline, interstitial and intracellular fluids are within minutes drawn into the vascular compartment as a result of osmotic gradients. Administration of 5 ml/kg body weight hypertonic saline leads to a degree of plasma expansion corresponding to 8-12 ml/kg. Results from major randomized studies on treatment of acute hypotension demonstrate that infusion of hypertonic saline leads to improved survival. Two case reports of patients suffering from severe septicaemia are presented in which infusion of hypertonic saline (7.5%) was performed in order to stabilize haemodynamic parameters. Case report no. I illustrates the rapid plasma expanding properties of hypertonic saline and no. II the effect on central haemodynamics with increased stroke volume and cardiac index. Consequently, hypertonic saline is considered an important supplement in the treatment of severe hypovolaemic or septic shock.