Protective effect of hypertonic saline on pulmonary edema in rats with blast injuries compli-cated by hemorrhagic shock

Ouyang Xingnan; Zhu Yu; Wu Yue; Li Qinghui; Peng Xiaoyong; Xiang Xinming; Li Tao

doi:10.3969/j.issn.1009-4237.2025.08.002

Abstract：Objective To observe the therapeutic effect of 3％and 7.5％(w/v)hypertonic saline on pul-monary edema in rats with blast injuries complicated by hemorrhagic shock.Methods A total of 200 healthy Spra-gue-Dawley rats[10 weeks old,body weight:(200.0±20.0)g]were randomly divided into five groups(n=40per group):sham group,blast injury complicated by hemorrhagic shock group,Lactated Ringer's solution(LR)resus-citation group,3％hypertonic saline+LR resuscitation group,and 7.5％hypertonic saline+LR resuscitation group.This composite injury model was established first by using a blast shock wave and a thermal radiation system to in-duce blast injuries,and then by controlled hemorrhage via withdrawing 40％of the total blood volume to induce hem-orrhagic shock.At the end stage of shock,resuscitation was performed in three groups:LR alone as a base,and combined infusion of LR+3％or 7.5％hypertonic saline,respectively.Lung vascular permeability,pulmonary water content,organ function,and rat survival rate were measured to evaluate the therapeutic effects of hypertonic saline on pulmonary edema.Results The blast injury combined with hemorrhagic shock model was successfully established,and the model rats exhibited typical signs of shock,along with significantly increased vascular permeability in the lung,kidney,brain,and intestine(all P＜0.001 compared with sham group),accompanied by organ dysfunction.Ar-terial blood gas analysis indicated acidosis and hypoxia,with significantly decreased mean arterial pressure,heart rate,and tissue perfusion(all P＜0.001 compared with sham group).The LR resuscitation alone reduced Evans blue(EB)content in various tissues,and improved certain blood gas parameters and tissue perfusion,specifically in terms of increasing perfusion in the kidney and intestine(P＜0.05 compared with the blast injury complicated by hemorrhagic shock group),while liver perfusion,organ function,and water content in the lung and brain showed no significant improvement(all P＞0.05).Based on LR resuscitation,the combined infusion of 3％and 7.5％hyper-tonic saline significantly improved vascular permeability and organ function(P＜0.05 compared with the LR resusci-tation group).Although differences were observed between the two different concentrations,i.e.,permeability,phys-iological parameters,and tissue perfusion,there were no statistically significant differences in final survival rate and organ functional improvement(both P＞0.05).Conclusion Hypertonic saline can significantly alleviate pulmonary edema and vascular leakage in rats with blast injuries complicated by hemorrhagic shock,which also improves the or-gan function.Although no statistically significant differences were found between 3％and 7.5％hypertonic saline in terms of survival rate and organ protection,3％hypertonic saline is more recommended considering the safety and clinical application,which warrants further investigation.