Evidence map›Paper›PMID 34480632›Full record

Trial reportEuropean journal of applied physiology2021

Bolus intravenous 0.9% saline leads to interstitial permeability pulmonary edema in healthy volunteers.

Hanmo Li, Andrew Bersten, Ubbo Wiersema, David Schembri, Elena Cavallaro, Dani-Louise Dixon, Shailesh Bihari

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in European journal of applied physiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Hanmo LiIntensive and Critical Care Unit, Flinders Medical Centre, Bedford Park, SA, 5042, Australia. Hanmo.Li@sa.gov.au.ORCID http://orcid.org/0000-0002-9597-3571
Andrew BerstenIntensive and Critical Care Unit, Flinders Medical Centre, Bedford Park, SA, 5042, Australia.
Ubbo WiersemaIntensive and Critical Care Unit, Flinders Medical Centre, Bedford Park, SA, 5042, Australia.
David SchembriRespiratory Functions Laboratory, Flinders Medical Centre, Bedford Park, SA, Australia.
Elena CavallaroDepartment of Critical Care Medicine, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Dani-Louise DixonIntensive and Critical Care Unit, Flinders Medical Centre, Bedford Park, SA, 5042, Australia.
Shailesh BihariIntensive and Critical Care Unit, Flinders Medical Centre, Bedford Park, SA, 5042, Australia.
Flinders University · AUFlinders Medical Centre · AU

Funding

Flinders Medical Centre Foundation 01.577.40388
6 · The paper itself

Abstract

purposeBolus intravenous administration of 0.9% saline has been associated with the development of pulmonary edema, and increased mortality. An animal model has previously demonstrated that rapid intravenous administration of 0.9% saline was associated with non-hydrostatic lung injury with increased lung lavage protein. We hypothesized that this non-hydrostatic effect would also occur in human volunteers.

methodsIn a randomized, cross-over study of 14 healthy male subjects, the lung lavage protein concentration and cardiorespiratory effects of an intervention with rapid intravenous administration of 30 mL/kg of 0.9% saline were compared with sham intervention. Bronchoalveolar lavage (BAL) was performed after fluid administration. Doppler echocardiography, lung ultrasound, pulmonary function tests, and blood sampling were performed before and after each intervention.

resultsThe BAL total protein concentration was greater after 0.9% saline administration than with sham (196.1 µg/mL (SD 87.6) versus 129.8 µg/mL (SD 55.4), respectively (p = 0.020). Plasma angiopoietin-2 concentration was also increased to 2.26 ng/mL (SD 0.87) after 0.9% saline administration compared with sham 1.53 ng/mL (SD 0.69) (p < 0.001). There were small increases in stroke volume (from 58 mL (IQR 51-74) to 66 mL (IQR 58-74), p = 0.045) and Doppler echocardiography left ventricle E/e' ratio (from 5.0 (IQR 4.5-6.0) to 5.7 (IQR 5.3-6.3), p = 0.007), but no changes to right ventricular function.

conclusionRapid intravenous administration of 0.9% saline leads to interstitial permeability pulmonary edema in healthy human volunteers. Further research is now warranted to understand these effects in critically ill patients.

Indexed as

AdultBiomarkersBronchoalveolar LavageCross-Over StudiesEchocardiography, DopplerHealthy VolunteersHumansInjections, IntravenousMalePermeabilityProspective StudiesPulmonary EdemaRespiratory Function TestsSaline SolutionUrinalysisBiomarkersSaline Solution0.9% salineBronchoscopyEchocardiographyLung injuryPermeability pulmonary edema

Identifiers

PMID34480632
OpenAlexW3198844125

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.