ArticleCritical care (London, England)2017
Low-volume resuscitation with normal saline is associated with microvascular endothelial dysfunction after hemorrhage in rats, compared to colloids and balanced crystalloids.
Article in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07035509 (Randomized Control Study on Normal Saline vs Plasmalite vs Plasma in REsuscitation of SEpsis Trial), which is not on this map. Cited by 47 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Randomized Control Study on Normal Saline vs Plasmalite vs Plasma in REsuscitation of SEpsis Trial (RESET) - A Feasibility and Comparative Study
Who cites it
47 citing papers in PubMed, 2 syntheses or guidelines pooled it, 108 citations in OpenAlex.
- Acute compartment syndrome in tibial fractures: a meta-analysis.BMC musculoskeletal disorders · 2025Pooled it
- Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine.Intensive care medicine · 2021Guideline
- The effect of plasma versus crystalloids on intravascular volume, tissue perfusion and tissue oxygenation: a randomized controlled trial in a human endotoxemia model.Critical care (London, England) · 2026Trial
- The effects of balanced crystalloid versus plasma on endothelial injury, systemic inflammation, and coagulation in experimental endotoxaemia: a randomised human volunteer study.British journal of anaesthesia · 2026Trial
- Effect of 5% albumin on endothelial glycocalyx degradation during off-pump coronary artery bypass.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Trial
- Effect of targeted coagulopathy management and 5% albumin as volume replacement therapy during lung transplantation on allograft function: a secondary analysis of a randomized clinical trial.BMC pulmonary medicine · 2023Trial
- Advancing Microcirculatory Therapies in Pediatric Sepsis: Current Opportunities and Future Directions.Journal of intensive care medicine · 2026Review
- Relationship between red cell distribution width to albumin ratio (RAR) and mortality in ICU patients with sepsis-associated ARDS: a retrospective study based on MIMIC-IV.BMC infectious diseases · 2026Article
- Rethinking Fluid Resuscitation in Septic Shock: A Phase-Adapted, Endothelium-Sparing Approach to Mitigate Capillary Leak.Journal of inflammation research · 2026Article
- Management of endothelial dysfunction in septic shock: role of albumin administration.Journal of intensive care · 2025Article
- Effects of fluids on sublingual microcirculation: a point of view review.Annals of intensive care · 2025Review
- Serum hyaluronic acid in critically ill dogs and influence of intravenous fluid therapy.PloS one · 2025Article
- Plasma attenuates endothelial injury compared to crystalloids in a ventilated rat pneumosepsis model.PloS one · 2025Article
- Association between normal saline infusion volume in the emergency department and acute kidney injury in heat stroke patients: a multicenter retrospective study.Renal failure · 2024Article
- Liposomal nanocarriers of preassembled glycocalyx restore normal venular permeability and shear stress sensitivity in sepsis: assessed quantitatively with a novel microchamber system.American journal of physiology. Heart and circulatory physiology · 2024Article
- Analysis of hemodynamics and impedance using bioelectrical impedance analysis in hypovolemic shock-induced swine model.Scientific reports · 2024Article
- Contemporary management of major haemorrhage in critical care.Intensive care medicine · 2024Review
- Capillary leak and endothelial permeability in critically ill patients: a current overview.Intensive care medicine experimental · 2023Review
- Edema and lymphatic clearance: molecular mechanisms and ongoing challenges.Clinical science (London, England : 1979) · 2023Review
- Resuscitating the Endothelial Glycocalyx in Trauma and Hemorrhagic Shock.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRestoration of endothelial glycocalyx (EG) barrier may be an essential therapeutic target for successful resuscitation. The aim of this study was to compare in vivo the effects of resuscitation with normal saline (NS) to lactated Ringer's solution (LR), 5% albumin and fresh frozen plasma (FFP) on their ability to maintain EG and barrier function integrity, mitigate endothelial injury and inflammation, and restore vascular homeostasis after hemorrhagic shock.
methodsAnesthetized rats (N = 36) were subjected to hemorrhagic shock (bled 40% of total blood volume), followed by resuscitation with 45 ml/kg NS or LR, or 15 ml/kg 5% albumin or FFP. Microhemodynamics, EG thickness, permeability, leukocyte rolling and adhesion were assessed in >180 vessels from cremaster muscle, as well as systemic measures.
resultsAfter hypotensive resuscitation, arterial pressure was 25% lower than baseline in all cohorts. Unlike FFP, resuscitation with crystalloids failed to restore EG thickness to baseline post shock and shedding of glycocalyx proteoglycan was significantly higher after NS. NS decreased blood flow and shear, and markedly increased permeability and leukocyte rolling/adhesion. In contrast, LR had lesser effects on increased permeability and leukocyte rolling. Albumin stabilized permeability and white blood cell (WBC) rolling/adhesion post shock, comparable to FFP.
conclusionsResuscitation with NS failed to inhibit syndecan-1 shedding and to repair the EG, which led to loss of endothelial barrier function (edema), decline in tissue perfusion and pronounced leukocyte rolling and adhesion. Detrimental effects of NS on endothelial and microvascular stabilization post shock may provide a pathophysiological basis to understand and prevent morbidity associated with iatrogenic resuscitation after hemorrhagic shock.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.