RESUSCITATION OF PULMONARY CONTUSION - HYPERTONIC SALINE IS NOT BENEFICIAL

We postulated that hypertonic solutions could minimize the accumulatio n of lung water and subsequent respiratory derangements that occur aft er pulmonary contusion. Anesthetized pigs underwent contusion of the r ight chest at baseline and then were hemorrhaged (30 cc/kg) over 20 mi n. They were resuscitated with either 7.5% NaCl (4 cc/kg) or .9% salin e (90 cc/kg) for 20 min and observed for 4 h. Gravimetric lung weights and spiral computed tomography scans were used to quantitate lung wat er. The hemodynamic response to contusion and hemorrhage was similar i n both resuscitation groups. Arterial oxygen tension was not significa ntly altered by the method of resuscitation and remained close to base line values for the entirety of the experiment. Static compliance meas urements were significantly decreased from baseline in both groups fol lowing pulmonary contusion. There were no differences in wet to dry lu ng weights or computed tomography scan injury volume between groups. W e conclude that small volume hypertonic saline resuscitation does not reduce the magnitude of lung injury or provide substantial physiologic benefit over isotonic solutions following pulmonary contusion.