HYPERTONIC HYPERONCOTIC FLUIDS REVERSE PROSTAGLANDIN E(2) (PGE(2))-INDUCED T-CELL SUPPRESSION/

In recent years, hypertonic, and hyperoncotic fluids have been examine d for their potential to replace conventional isotonic fluids. This st udy describes the effects of commonly used intravenous fluids on immun e function. The action of increased concentrations of hypertonic salin e (HTS), hypertonic saline-dextran (HSD), dextran (Dx), albumin (ALB), and hydroxyethylstarch (HET) on in vitro proliferation of phytohemagg lutinin-stimulated normal and prostaglandin E(2)-suppressed human peri pheral blood mononuclear cells was tested. At clinically relevant leve ls, HTS, HSD (20-40 mM hypertonicity), and ALB (2.5 mg/mL) enhanced T- cell proliferation by 65, 75, and 70%, respectively. Dx and HET had li ttle effect. HTS also reversed prostaglandin E(2)-suppressed (10 ng/mL ) T-cell proliferation to normal levels, and HSD enhanced T-cell proli feration by 40%, in contrast to Dx, ALB, and HET which had minimal eff ects. The results suggest that hypertonic/hyperoncotic solutions might improve prostaglandin-mediated suppression of T-cell function in pati ents and may be a useful adjunct to reduce the risk of infection.