Effects of hypertonic saline on myocardial contractility in anaesthetized pigs

The cardiac effects of hypertonic saline (HS, 7.5% NaCl) were evaluated using a number of indices derived from the left ventricular (LV) pressurevolume relationship. Left ventricular end-systolic elastance (elastance), the slope of the endsystolic pressure-volume relationship, end-systolic elastance normalized for enddiastolic volume (elastance(_norm), the rate of rise of LV pressure (dP/dt_max), and dP/dt_max/end-diastolic volume were used to assess myocardial contractility. Pigs were anaesthetized with isoflurane and instrumented for haemodynamic measurements, LV pressure, and volume (conductance catheter) determinations. Elastance was determined during transient (8–10 s) caudal vena caval balloon occlusion. Following instrumentation, the end-tidal isoflurane concentration was reduced and maintained at 1 minimum alveolar concentration (1.5%). Pigs were randomly administered either 0.9% NaCl (n= 7) or HS (n =9) at a dose of 4 ml/kg, over 3 min into the right atrium. There were no significant differences in LV or haemodynamic measurements between isotonic saline and HS treated pigs at any time point. Elastance, elastance(_norm) and dP/dt_max/end-diastolic volume did not change in either treatment group. In contrast, dP/dt_max) increased significantly (P < 0.015) at 5 min compared to baseline after treatment with HS. End-diastolic volume increased significantly from 5 to 30 min following treatment with HS. Left ventricular end-diastolic pressure increased significantly at 5 and 60 min in HS treated pigs. Central venous and pulmonary arterial wedge pressures, and cardiac index increased significantly at 5 min after treatment with HS. Total peripheral resistance decreased significantly at 5 min, followed by a return to baseline in the HS group. These results suggest that HS is not a positive inotrope in the anaesthetized pig and that increases in cardiac index are primarily due to an increased preload.