The current report summarizes our findings with a small subgroup of trauma patients of the larger ROC trial [21]. In this subgroup of patients, we assessed a number of immunological parameters to determine how hypertonic fluids affect the inflammatory response to trauma. This subgroup included a total of 34 patients with hemorrhagic shock who were enrolled in the ROC study sites in Seattle and Toronto. Of the 34 patients, 9 received 250 ml HS, 8 received an equal volume of HSD, and 17 patients received 250 ml of NS (Table 1). There were no significant differences between these 3 treatment groups with regards to gender distribution, age, type of injury, and injury severity scores (ISS). The average multiple organ dysfunction score (MODS) of patients treated with NS was higher than those of the HS and HSD groups, but these differences were not statistically significant. However, patients treated with HS arrived in the emergency department with an average systolic blood pressure that was significantly higher than in the other treatment groups (Table 1). All of the patients treated with HSD or HS survived, while two patients in the NS group died within a week after hospitalization. Interestingly, while the average systolic blood pressures in the HS group was higher than in the HSD group, these differences could not be explained by corresponding sodium levels. As expected, the average plasma sodium concentrations in patients treated with HS and HSD were similar and significantly higher than in the NS group with sodium levels ranging in the lower bracket of normal values for healthy adult controls.
Leukocyte and neutrophil counts in all patients were significantly elevated compared to agematched healthy controls (Fig. 1). While leukocyte and neutrophil counts generally
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decreased after admission, they remained significantly elevated above healthy control values throughout the 24-h observation period. Total leukocyte counts did not differ among patient groups. However, the initial neutrophil count in the HS group was significantly lower than in the NS group