• Ricardo Costa Petroni, Paolo Jose Cesare Biselli, Thais Martins de Lima, Mariana Cardillo Theobaldo, Elia Tamaso Caldini, Rosângela Nascimento Pimentel, Hermes Vieira Barbeiro, Suely Ariga Kubo, Irineu Tadeu Velasco, and Francisco Garcia Soriano.
• Emergency Medicine Department, Medical School, University of São Paulo, São Paulo, Brazil. ricardopetroni@uol.com.br.
• Inflammation. 2015 Dec 1; 38 (6): 2026-35.

AbstractAcute respiratory distress syndrome (ARDS) is the most severe lung inflammatory manifestation and has no effective therapy nowadays. Sepsis is one of the main illnesses among ARDS causes. The use of fluid resuscitation is an important treatment for sepsis, but positive fluid balance may induce pulmonary injury. As an alternative, fluid resuscitation with hypertonic saline ((HS) NaCl 7.5%) has been described as a promising therapeutical agent in sepsis-induced ARDS by the diminished amount of fluid necessary. Thus, we evaluated the effect of hypertonic saline in the treatment of LPS-induced ARDS. We found that hypertonic saline (NaCl 7.5%) treatment in rat model of LPS-induced ARDS avoided pulmonary function worsening and inhibited type I collagen deposition. In addition, hypertonic saline prevented pulmonary injury by decreasing metalloproteinase 9 (MMP-9) activity in tissue. Focal adhesion kinase (FAK) activation was reduced in HS group as well as neutrophil infiltration, NOS2 expression and NO content. Our study shows that fluid resuscitation with hypertonic saline decreases the progression of LPS-induced ARDS due to inhibition of pulmonary remodeling that is observed when regular saline is used.

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