Systemic and renal haemodynamic effects of fluid bolus therapy: sodium chloride versus sodium octanoate-balanced solution.

Abstract

Solutions with high chloride concentrations, like normal saline (NS), may adversely affect renal blood flow (RBF). We compared the systemic and renal haemodynamic effects of a bolus of NS with those of a novel isotonic solution containing a physiological concentration of chloride and sodium octanoate (SOct) in healthy conscious sheep.We performed an experimental double-blind cross-over animal study. After chronic pulmonary and renal artery flow probe insertion, animals were randomly assigned to receive rapid intravenous infusion (1 L over 30 minutes) of either NS or SOct. Haemodynamic parameters were recorded continuously before and after treatment.NS and SOct had similar dilutional effects on the haematocrit. Both induced a short-lived increase in cardiac output (CO) and total peripheral conductance which dissipated by 60 minutes. However, SOct increased RBF more than NS (peak values, 213.4±34.3mL/min v 179.3±35.6mL/min; P < 0.001) with a greater RBF/CO ratio (peak values, 12.2%±3.7% v 10.6%±3.6%; P < 0.001).NS and SOct appear to have similar systemic haemodynamic effects. However, OS significantly increases RBF compared with normal saline.