Safety of Hypertonic Saline as Fluid Resuscitation in Sepsis:A Meta-analysis

LIANG Yu-peng; LI Jie; ZHAO Xin; ZHANG Guo-xiu

doi:10.13730/j.issn.1009-2595.2017.05.010

Abstract：Objective To evaluate the safety of hypertonic saline solution as fluid resuscitation for patients with sepsis and septic shock.Methods Datebase from PubMed,Embase,Cochrane library,China National Knowledge Infrastructure (CNKI) and Wanfang database were selected to randomized controlled trail about hypertonic saline as fluid resuscitation therapy for patients with sepsis and septic shock from inception to July 2016.Two reviewers independently screened literatures according to inclusion and excluding criteria,extracted data,assessed methodological qualities of included studies,and conducted a meta-analysis by using RevMan 5.3.5 software.Results Five studies were selected and included 208 patients.Meta analysis results showed no differences were found in 28-day mortality [RR=1.02,95%CI (0.79,1.32),P=0.86],achieved rate of early goal-directed therapy (EGDT) [RR=1.11,95%CI (0.94,1.31),P=0.22],use of hyperensort [RR=1.01,95%CI (0.89,1.16),P=0.84],use of hyperensort more than 3 days[RR=0.95,95%CI (0.76,1.20),P=0.68] between hypertonic saline solution group and 0.9% saline solution group.However,total fluid volume in hypertonic saline solution group was lower than that in 0.9% saline solution group [MD=-1 097.90,95%CI (-1 295.26,-900.53),P<0.000 01].Conclusion No significantly differences are found in 28-day mortality,achieved rate of EGDT and uses of hyperensort between hypertonic saline solution group and 0.9% saline solution group.However, total fluid volume in hypertonic saline solution group was lower than that in 0.9% saline solution group.The results of meta-analysis are restricted to quantities and qualities of included studies.This conclusion still needs more high quality studies to verify.