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Annals of Intensive Care

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Open Access 01-12-2011 | Research

The effects of hypertonic fluid administration on the gene expression of inflammatory mediators in circulating leucocytes in patients with septic shock: a preliminary study

Authors: Frank MP van Haren, James Sleigh, Ray Cursons, Mary La Pine, Peter Pickkers, Johannes G van der Hoeven

Published in: Annals of Intensive Care | Issue 1/2011

Abstract

Objective

This study was designed to investigate the effect of hypertonic fluid administration on inflammatory mediator gene expression in patients with septic shock.

Design and setting

Prospective, randomized, controlled, double-blind clinical study in a 15-bed mixed intensive care unit in a tertiary referral teaching hospital.

Interventions

Twenty-four patients, who met standard criteria for septic shock, were randomized to receive a bolus of hypertonic fluid (HT, 250 ml 6% HES/7.2% NaCl) or isotonic fluid (IT, 500 ml 6% HES/0.9% NaCl) administered over 15 minutes. Randomization and study fluid administration was within 24 hours of ICU admission for all patients. This trial is registered with ANZCTR.org.au as ACTRN12607000259448.

Results

Blood samples were taken immediately before and 4, 8, 12, and 24 hours after fluid administration. Real-time reverse transcriptase polymerase chain reaction (RT rtPCR) was used to quantify mRNA expression of different inflammatory mediators in peripheral leukocytes. In the HT group, compared with the IT group, levels of gene expression of MMP9 and L-selectin were significantly suppressed (p = 0.0002 and p = 0.007, respectively), and CD11b gene expression tended to be elevated (p = NS). No differences were found in the other mediators examined.

Conclusions

In septic shock patients, hypertonic fluid administration compared with isotonic fluid may modulate expression of genes that are implicated in leukocyte-endothelial interaction and capillary leakage.

The study was performed at the Intensive Care Department, Waikato Hospital, and at the Molecular Genetics Laboratory, University of Waikato, Hamilton, New Zealand.

Trial registration

Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12607000259448

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Title: The effects of hypertonic fluid administration on the gene expression of inflammatory mediators in circulating leucocytes in patients with septic shock: a preliminary study
Authors: Frank MP van Haren
James Sleigh
Ray Cursons
Mary La Pine
Peter Pickkers
Johannes G van der Hoeven
Publication date: 01-12-2011
Publisher: Springer Paris
Published in: Annals of Intensive Care / Issue 1/2011
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/2110-5820-1-44

At a glance: The STEP trials

Springer Medicine

The effects of hypertonic fluid administration on the gene expression of inflammatory mediators in circulating leucocytes in patients with septic shock: a preliminary study

Abstract

Objective

Design and setting

Interventions

Results

Conclusions

Trial registration

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Design and setting

Interventions

Results

Conclusions

Trial registration

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