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Acetylcholinesterase activity of the polychaete Nereis diversicolor: effects of temperature and salinity.

In order to estimate the potential use of the mean wholebody acetylcholinesterase (AChE) activity from the ragworm Nereis diversicolor for the biological assessment of pollution by anticholinesterase agents in estuarine areas, we measured the effects of the main abiotic factors (i.e. temperature and salinity) on AChE activity. We report here that AChE activity tends to decrease in individuals sampled in tanks at a salinity of 30 per thousand as temperature increases. No tendencies in the evolution of AChE activity were observed in individuals sampled in tanks at a salinity of 15 per thousand. In contrast, salinity seems to have a greater effect on AChE activity than temperature. At a temperature of 12 degrees C, a salinity of 30 per thousand provokes a significant transient increase of AChE 2 days after the beginning of the maintenance period compared with a salinity of 15 per thousand. The effects are short-term stress effects. We noticed only a transient increase of AChE activity between 2 days for individuals maintained in tanks at temperature of 20 degrees C and salinity of 15 and 30 per thousand, respectively, and 8 days for individuals maintained in tanks at salinity of 30 per thousand and at a temperature of 12 degrees C after the beginning of the maintenance period, confirming the more pronounced effect of salinity over temperature.

Acetylcholinesterase↗

Changes in free amino acids in the hemolymph of giant freshwater prawn Macrobrachium rosenbergii exposed to varying salinities: relationship to osmoregulatory ability.

Changes in free amino acids (FAA) in the hemolymph of the giant freshwater prawn, Macrobrachium rosenbergii, were examined in individuals exposed to varying salinities for up to 1 week. In freshwater and under conditions of low salinity, total FAA concentrations were maintained between approximately 0.85 and 1 mM and did not exhibit changes in response to salinity exposure. Under high salinities, total FAA concentrations increased dramatically, reaching up to 2.1 mM depending on treatment. Examination of individual amino acid concentrations revealed that these increases were based on specific changes in glycine, arginine, alanine, proline and lysine. Among these, alanine showed the greatest increases, resulting in levels six-fold higher under high salinity than in freshwater and under low salinity. The other amino acid species showed increases of 2.5-fold compared to original values. These five FAAs in freshwater and under low salinity together occupied approximately 45% of total FAA contents and under high salinity comprised more than 70% of total FAA contents. These results suggest that specific hemolymph FAAs are involved in mediating response to salinity exposure in freshwater prawns.

Amino Acids↗

Alterations in Ca2+-ATPase activity and calcium-binding protein regucalcin mRNA expression in the kidney cortex of rats with saline ingestion.

The alteration in calcium metabolism in rats ingested with saline was investigated. Rats were freely given saline as drinking water for 2 and 7 days. Calcium concentration in the serum was significantly elevated by saline ingestion for 2 and 7 days, while serum inorganic phosphorus concentration was not altered. Serum urea nitrogen concentration was significantly increased by saline ingestion for 7 days. Calcium content in the femoral-diaphyseal and metaphyseal tissues was not altered by saline ingestion for 7 days. Calcium content in the kidney cortex was significantly elevated by saline ingestion for 7 days. Ca2+-ATPase activity in the basolsateral membranes of kidney cortex was clearly increased by saline ingestion for 2 and 7 days. The enzyme activity was not altered by the addition of sodium chloride (10(-3) and 10(-2) M), parathyroid hormone (10(-7) and 10(-6) M), and calcitonin (3 x 10(-8) and 3 x 10(-7) M) in the enzyme reaction mixture. A calcium-binding protein regucalcin mRNA expression in the kidney cortex was markedly suppressed by saline ingestion for 7 days, although such a suppression was not seen for 2 days. These results suggest that saline ingestion causes the disturbance of calcium transport system in the kidney cortex of rats, and that the renal disorder may induce hypercalcemia.

Animals↗

Randomized trial comparing albumin and saline in the prevention of paracentesis-induced circulatory dysfunction in cirrhotic patients with ascites.

Paracentesis-induced circulatory dysfunction (PICD) is a recently described complication that can be prevented with the administration of plasma expanders. The aim of this study was to compare the efficacy of saline versus albumin in the prevention of PICD. Patients were randomized to receive albumin or saline after total paracentesis. Patients readmitted as a consequence of a second episode of tense ascites were treated with total paracentesis and the alternative plasma expander. After randomization, 35 patients received saline and 37 received albumin. Twenty-one patients were readmitted for tense ascites and treated with the alternative expander. Significant increases in plasma renin activity (PRA) were found 24 hours and 6 days after paracentesis when saline was used (baseline, 5.6 +/- 5.7; 24 hours, 7.6 +/- 6.9; 6 days, 8.5 +/- 8.0 ng x mL(-1). hr(-1); P <.05 and P <.01 vs. baseline, respectively), whereas no significant changes were observed with albumin. The incidence of PICD was significantly higher in the saline group versus the albumin group (33.3% vs. 11.4%, respectively; P =.03). However, no significant differences were found when less than 6 L of ascitic fluid was evacuated (6.7% vs. 5.6% in the saline and albumin groups, respectively; P =.9). Similar results were observed when analyzing patients who received 2 consecutive paracentesis (i.e., a significant increase in PRA after saline [P <.01] without significant variations after albumin). In conclusion, albumin is more effective than saline in the prevention of PICD. Saline is a valid alternative to albumin when less than 6 L of ascitic fluid is evacuated.

Aged↗

The injection of intrathecal normal saline reduces the severity of postdural puncture headache.

BACKGROUND AND OBJECTIVES: We investigated whether the injection of 10 mL of normal saline into the subarachnoid space following accidental dural puncture reduced the incidence of postdural puncture headache (PDPH) and the need for epidural blood patch (EBP). METHODS: Twenty-eight patients who experienced accidental dural puncture with an epidural needle had 10 mL of normal saline injected into the subarachnoid space. In 22 patients, the injection was performed immediately through the epidural needle. In 6 patients who had intrathecal catheters placed through the epidural needle, the saline was injected through the catheter before removal. All other patients who experienced wet taps during the same period that the study was in progress but did not receive the saline injection served as a control group, 26 in number. Patients with severe or persistent PDPHs were treated with EBP. RESULTS: Of those patients who received intrathecal normal saline immediately through the epidural needle, 32% developed a headache compared with 62% of controls. Of these, 1 patient who received saline required EBP compared with nine in the control group (P =.004). Of those patients who had intrathecal catheters placed, there were no headaches in the saline group of 6 compared with 3 in the control group of 5, 1 of whom was treated with EBP (P >.05). CONCLUSIONS: The immediate injection of 10 mL intrathecal normal saline after a wet tap significantly reduced the incidence of PDPH and the need for EBP. When an intrathecal catheter had been placed following a wet tap, injection of 10 mL of normal saline before its removal effectively prevented PDPH.

Blood Patch, Epidural↗

Wound irrigation in children: saline solution or tap water?

STUDY OBJECTIVE: Irrigation, a critical component of wound management, is commonly performed with sterile normal saline solution. The purpose of this study was to compare the infection rates of wounds irrigated with normal saline solution versus those of wounds irrigated with running tap water. METHODS: A prospective trial was conducted in an urban pediatric emergency department. Tap water pressure and flow rates were measured, and cultures were obtained before the study and at 5 months after study initiation. Patients 1 to 17 years of age presenting to the pediatric ED with a simple laceration were eligible. Exclusion criteria included immunocompromise, complicated lacerations, or current use of or need for antibiotics. Patients were allocated to the running tap water group or the standard normal saline solution irrigation group. Wounds were closed in standard fashion. Patients returned to the pediatric ED in 48 to 72 hours for evaluation. RESULTS: Two hundred seventy-one patients were enrolled in the normal saline solution group and 259 in the tap water group. Tap water and normal saline solution pressures and flow rates differed. The groups did not differ in terms of patient demographic characteristics or wound characteristics. However, more wounds were located on the hand in the tap water group (21.3%; 95% confidence interval [CI] 16.3% to 27.1%) compared with those in the normal saline solution group (9.2%; 95% CI 5.9% to 13.4%). The wound infection rates were similar in the 2 groups (normal saline solution group: 2.8% [95% CI 1.1% to 5.7%] versus running tap water group: 2.9% [95% CI 1.2% to 5.9%]). CONCLUSION: There were no clinically important differences in infection rates between wounds irrigated with tap water or normal saline solution. Tap water might be an effective alternative to normal saline solution for wound irrigation in children.

Adolescent↗

A comparison of vaginally administered misoprostol with extra-amniotic saline solution infusion for cervical ripening and labor induction.

OBJECTIVE: The purpose of this study was to compare intravaginal misoprostol with extra-amniotic saline solution infusion with concomitant oxytocin for cervical ripening and labor induction in viable pregnancies. STUDY DESIGN: Two hundred women with indications for labor induction and unfavorable cervices were assigned randomly to vaginal misoprostol or extra-amniotic saline solution infusion. Twenty-five micrograms of misoprostol was administered every 4 hours up to six doses, followed by intravenous oxytocin administration. Patients who had received extra-amniotic saline solution infusion also received intravenous oxytocin along with a maximum 12-hour saline solution infusion through Foley catheters that were placed above the internal cervical os. RESULTS: One hundred women were randomly assigned to misoprostol, and 100 women were assigned randomly to extra-amniotic saline solution infusion. The average interval from start of induction to vaginal delivery was longer in the misoprostol group (1323.3 +/- 700.3 minutes) than in the extra-amniotic saline solution infusion group (970.4 +/- 502.7 minutes; P =.006, log transformed data). Abnormal fetal heart rate tracings were found in 30% of the patients who received misoprostol and in 19% of the patients who received extra-amniotic saline solution infusion (relative risk, 1.6; 95% CI, 1.0-2.4; P =.05). There was more tachysystole in the misoprostol group (8%) than in the extra-amniotic saline solution infusion group (1%; P =.02). There were no differences in the routes of deliveries or neonatal outcomes between groups. CONCLUSION: Extra-amniotic saline solution infusion with oxytocin administration appears more effective and is associated with fewer maternal complications than misoprostol for cervical ripening and labor induction.

Catheterization↗

Saline as an alternative to air for filling the laryngeal mask airway cuff.

We have assessed a new method to evacuate saline completely from the laryngeal mask airway (LMA) cuff and tested the hypothesis that intracuff pressures, fibreoptic position and oropharyngeal leak pressures are similar for saline compared with air during nitrous oxide-oxygen anaesthesia. Eight size 4 LMA were inflated with saline 30 ml. After syringe evacuation, median residual weight was 0.56 (range 0.24-0.98) g; after additional manual cuff squeezing it was 0.26 (0.21-0.35) g; and after drying for 12 h at 60 degrees C with the valve open it was -0.02 (-0.05-0.04) g. Pressure-volume curves of four size 3-5 LMA showed that compliance was lower for the saline-filled cuff. A clinical study of 20 patients allocated randomly to have saline or air in the cuff showed a significant increase in intracuff pressure with air, but not saline, during nitrous oxide-oxygen anaesthesia. The fibreoptic position of the LMA changed more frequently in the air, compared with the saline-filled group (four of 10 vs none of 10; P = 0.04). Oropharyngeal leak pressures were similar between groups. We conclude that the saline-inflated LMA cuff was reliably emptied and more stable in terms of intracuff pressures and possibly fibreoptic position. Filling the LMA cuff with saline is a viable option during laser surgery to the airway.

Adolescent↗

World salinization with emphasis on Australia.

Salinization is the accumulation of water-soluble salts in the soil solum or regolith to a level that impacts on agricultural production, environmental health, and economic welfare. Salt-affected soils occur in more than 100 countries of the world with a variety of extents, nature, and properties. No climatic zone in the world is free from salinization, although the general perception is focused on arid and semi-arid regions. Salinization is a complex process involving the movement of salts and water in soils during seasonal cycles and interactions with groundwater. While rainfall, aeolian deposits, mineral weathering, and stored salts are the sources of salts, surface and groundwaters can redistribute the accumulated salts and may also provide additional sources. Sodium salts dominate in many saline soils of the world, but salts of other cations such as calcium, magnesium, and iron are also found in specific locations. Different types of salinization with a prevalence of sodium salts affect about 30% of the land area in Australia. While more attention is given to groundwater-associated salinity and irrigation salinity, which affects about 16% of the agricultural area, recent investigations suggest that 67% of the agricultural area has a potential for "transient salinity", a type of non-groundwater-associated salinity. Agricultural soils in Australia, being predominantly sodic, accumulate salts under seasonal fluctuations and have multiple subsoil constraints such as alkalinity, acidity, sodicity, and toxic ions. This paper examines soil processes that dictate the exact edaphic environment upon which root functions depend and can help in research on plant improvement.

Australia↗

Hypertonic saline lowers raised intracranial pressure in children after head trauma.

Eighteen pediatric patients who sustained traumatic brain injury were enrolled in a double-blind, crossover study comparing the effects of 3% saline and 0.9% saline infusions on raised intracranial pressure (ICP). After resuscitation, each patient received a bolus of each saline concentration, and ICP was monitored for 2 h. Initial mean ICP before 0.9% saline infusions equaled 19.3 mm Hg and averaged 20.0 mm Hg during the subsequent 2-h trials (p = 0.32). Baseline mean ICP before 3% saline administration equaled 19.9 mm Hg and averaged 15.8 mm Hg for 2 h postinfusion (p = 0.003). Central venous pressure did not change significantly in either group, nor did measurements of renal function. Serum sodium concentrations increased in all 18 trials of 3% saline. Maximal concentrations of serum sodium occurred 30 min after bolus administration of 3% saline. Three percent saline significantly reduces raised ICP after traumatic brain injury when compared with normal saline. Intravascular dehydration, as measured by central venous pressure, did not occur during the study period.

Journal Article↗

Carbon Isotope Discrimination, Gas Exchange, and Growth of Sugarcane Cultivars under Salinity.

Physiological features associated with differential resistance to salinity were evaluated in two sugarcane (Saccharum spp. hybrid) cultivars over an 8-week period during which greenhouse-grown plants were drip-irrigated with water or with NaCI solutions of 2, 4, 8, or 12 decisiemens (dS) m-1 electrical conductivity (EC). The CO2 assimilation rate (A), stomatal conductance (g), and shoot growth rate (SGR) began to decline as EC of the irrigation solution increased above 2 dS m-1. A, g, and SGR of a salinity-resistant cultivar (H69-8235) were consistently higher than those of a salinity-susceptible cultivar (H65-7052) at all levels of salinity and declined less sharply with increasing salinity. Carbon isotope discrimination ([delta]) in tissue obtained from the uppermost fully expanded leaf increased with salinity and with time elapsed from the beginning of the experiment, but [delta] was consistently lower in the resistant than in the susceptible cultivar at all levels of salinity. Gas-exchange measurements suggested that variation in [delta] was attributable largely to variation in bundle sheath leakiness to CO2 ([phi]). Salinity-induced increases in [phi] appeared to be caused by a reduction in C3 pathway activity relative to C4 pathway activity rather than by physical changes in the permeability of the bundle sheath to CO2. A strong correlation between [delta] and A, g, and SGR permitted these to be predicted from [delta] regardless of the cultivar and salinity level. [delta] thus provided an integrated measure of several components of physiological performance and response.

Journal Article↗

Content of adenosine phosphate compounds in pea roots grown in saline media.

The levels of ATP, ADP and AMP, the activity of phosphatases, and the ability for oxidative phosphorylation were studied in roots of pea (Pisum sativum) plants grown in media salinized either with NaCl or Na(2)SO(4). In response to salinity, the ATP level in the roots decreased, whereas the ADP level increased slightly. As a result, the ADP:ATP ratio in the tissue increased with increasing salinity in the growth medium. The AMP level in the tissue was not affected by salinity.Phosphatase activity (using p-nitrophenyl phosphate and ATP as substrates), in the soluble and in the mitochondrial fractions from roots grown in NaCl-salinized media, was considerably higher than in the control roots. In the mitochondrial fraction of the roots grown in Na(2)SO(4)-salinized media, such an increase was not observed.The phosphorylating activity of mitochondria was depressed by the two types of salinity, but was more sensitive to NaCl salinity. In mitochondrial suspensions prepared from roots exposed to salinity, practically no phosphorylation could take place if nicotinamide adenine dinucleotide was omitted from the reaction mixture; but even when added, the restoration of phosphorylative ability was not complete. Addition of NaCl to the reaction mixture did not affect the activity of the phosphatases. Addition of Na(2)SO(4) to the reaction mixture depressed, in some cases, the activity of the acid phosphatase. Phosphorylative activity was affected, however, by both types of salinity: presence of either NaCl or Na(2)SO(4) at - 1 atm in the reaction mixture increased phosphorylative activity, and higher concentrations (-3 and -5 atm) depressed it.

Journal Article↗

A comparison of outpatient hysteroscopy with saline infusion hysterosonography.

OBJECTIVES: To establish the accuracy of saline infusion hysterosonography in diagnosing uterine pathology when compared with outpatient hysteroscopy. DESIGN: Prospective, parallel, blinded comparative study. SETTING: Outpatient hysteroscopy clinic in a large university teaching hospital. POPULATION: All women referred for outpatient hysteroscopy in a 15-month period. INTERVENTIONS: Women underwent saline infusion hysterosonography followed by flexible hysteroscopy. The ultrasonographer was blinded to the hysteroscopy result and the gynaecologist was blinded to the saline infusion hysterosonography result. MAIN OUTCOME MEASURES: The relative success rates and pain scores for each procedure. The validity of saline infusion hysterosonography as a diagnostic test. RESULTS: One hundred and seventeen women entered the study; 70 women were premenopausal and 47 postmenopausal. In 27 women, one or both procedures could not be performed. Saline infusion hysterosonography failed in 20 women, on one occasion hysteroscopy failed and both investigations failed in six women. Ninety cases remained for direct comparison, with 78 cases of agreement on the uterine findings in both investigations. Twelve cases disagreed; in one case, an adhesion was seen, two cases with polyps and five with fibroids seen on ultrasound but not seen on hysteroscopy. There were four cases where polyps were identified on hysteroscopy but not on saline infusion hysterosonography. The median pain scores were 1.6 for saline infusion hysterosonography and 3.2 for hysteroscopy. CONCLUSIONS: Both saline infusion hysterosonography and hysteroscopy are well tolerated by women. Saline infusion hysterosonography has a high failure rate but has a lower pain score than hysteroscopy.

Adult↗

The effect of saline and hyperoncotic dextran infusion on canine ileal salt and water absorption and regional blood flow.

1. The unidirectional Na and H2O fluxes, vascular pressures and total and absorptive site blood flows in the canine ileum were determined before and during I.V. saline infusion and subsequent I.V. infusion of hyperoncotic dextran. The intestinal perfusion solutions were isotonic saline or isotonic saline and mannitol, but the effects of I.V. saline or I.V. hyperoncotic dextran infusion were generally the same for both luminal solutions. 2. Continuous I.V. infusion of saline caused a continuous increase in the unidirectional flux of Na and H2O into the ileal lumen, an increase in total blood flow, and an increase in venous pressure. 3. The net absorption of Na and H2O was decreased by I.V. saline infusion. 4. The unidirectional fluxes of Na and H2O out of the lumen, arterial pressure, and absorptive site blood flow were not affected by I.V. saline infusion. 5. I.V. hyperoncotic dextran infusion reversed most of the effects of saline infusion. 6. The unidirectional fluxes of Na and H2O into the lumen were significantly correlated with Starling forces during I.V. saline infusion. 7. It was concluded that intestinal transport of salt and water was subject to regulation by physical forces at the capillary level.

Animals↗

Differential responses of nitrogen-fixing cyanobacteria to salinity and osmotic stresses.

Two nitrogen-fixing Anabaena strains were found to be differentially tolerant to salinity and osmotic stresses. Anabaena torulosa, a brackish-water, salt-tolerant strain, was relatively osmosensitive. Anabaena sp. strain L-31, a freshwater, salt-sensitive strain, on the other hand, displayed significant osmotolerance. Salinity and osmotic stresses affected nitrogenase activity differently. Nitrogen fixation in both of the strains was severely inhibited by the ionic, but not by the osmotic, component of salinity stress. Such differential sensitivity of diazotrophy to salinity-osmotic stresses was observed irrespective of the inherent tolerance of the two strains to salt-osmotic stress. Exogenously added ammonium conferred significant protection against salinity stress but was ineffective against osmotic stress. Salinity and osmotic stresses also affected stress-induced gene expression differently. Synthesis of several proteins was repressed by salinity stress but not by equivalent or higher osmotic stress. Salinity and osmotic stresses induced many common proteins. In addition, unique salt stress- or osmotic stress-specific proteins were also induced in both strains, indicating differential regulation of protein synthesis by the two stresses. These data show that cyanobacterial sensitivity and responses to salinity and osmotic stresses are distinct, independent phenomena.

Journal Article↗

Genome-wide transcriptional profiling analysis of adaptation of Bacillus subtilis to high salinity.

The gram-positive soil bacterium Bacillus subtilis often faces increases in the salinity in its natural habitats. A transcriptional profiling approach was utilized to investigate both the initial reaction to a sudden increase in salinity elicited by the addition of 0.4 M NaCl and the cellular adaptation reactions to prolonged growth at high salinity (1.2 M NaCl). Following salt shock, a sigB mutant displayed immediate and transient induction and repression of 75 and 51 genes, respectively. Continuous propagation of this strain in the presence of 1.2 M NaCl triggered the induction of 123 genes and led to the repression of 101 genes. In summary, our studies revealed (i) an immediate and transient induction of the SigW regulon following salt shock, (ii) a role of the DegS/DegU two-component system in sensing high salinity, (iii) a high-salinity-mediated iron limitation, and (iv) a repression of chemotaxis and motility genes by high salinity, causing severe impairment of the swarming capability of B. subtilis cells. Initial adaptation to salt shock and continuous growth at high salinity share only a limited set of induced and repressed genes. This finding strongly suggests that these two phases of adaptation require distinctively different physiological adaptation reactions by the B. subtilis cell. The large portion of genes with unassigned functions among the high-salinity-induced or -repressed genes demonstrates that major aspects of the cellular adaptation of B. subtilis to high salinity are unexplored so far.

Adaptation, Physiological↗

Hypotonic saline infusion alters the renal response to amino acids in men.

We investigated the effects of hypotonic saline-induced modifications of extracellular volume and sodium handling on the renal and metabolic response to amino acids (AA). Renal hemodynamics (Inutest, p-aminohippurate clearance), plasma AA, and glucagon levels, as well as urea and sodium excretion, were studied in seven adult volunteers infused for 2 h, on six separate occasions, according to the following protocols: 1) high-AA solution (300 mg. min-1. 1.73 m-2); 2) low-AA solution (150 mg. min-1. 1.73 m-2); 3) low AA + 2,000 ml/1.73 m2 of 0.23% saline solution; 4) high AA + 0. 23% saline; 5) high AA + 0.45% saline; and 6) 0.45% saline alone. The glomerular filtration rate (GFR) rise induced by the high-AA solution was similar to that induced by the low-AA solution (DeltaGFR = +24 +/- 6 and +20.2 +/- 7 ml. min-1. 1.73 m-2, respectively), whereas the plasma AA and glucagon levels and urea excretion rate increases were related to AA dose. The addition of 0. 23% saline to the low-AA solution and of 0.45% saline to the high-AA solution blunted the renal hemodynamic response (DeltaGFR = +6.6 +/- 10.1 and +11.4 +/- 8.3 ml. min-1. 1.73 m-2, respectively) without modifying the pattern of plasma AA and glucagon levels and urea excretion observed with the AA infusion alone. Urinary sodium excretion increased from baseline with each protocol and rose even further when saline was added to AA. A negative correlation (r = -0. 38, P < 0.05) was found between the changes from basal values in GFR and those in sodium excretion rate with high-AA infusion at different levels of sodium concentration. These data suggest that AA-induced hyperfiltration might be blunted by hypotonic saline infusion, possibly through an acute modification of renal sodium handling and extracellular volume.

Adult↗

Respiratory failure caused by intratracheal saline: additive effect of xanthine oxidase.

Administration of physiological saline or drugs together with saline into the airways is becoming common clinical practice. However, there are few studies on possible side effects. We have studied the effects of saline, saline plus xanthine oxidase, and saline plus xanthine oxidase plus superoxidase dismutase on lung-thorax compliance and on arterial blood gases in anesthetized, paralyzed guinea pigs, ventilated for 2.5 h. Saline bolus (2-3 ml isotonic saline/kg body weight) into the airways reduced the compliance within 20 min to a mean of 39% of the pretreatment levels, and necessitated as increase in the respirator pressure. Saline plus xanthine oxidase decreased the compliance to 16% of the pretreatment levels. The xanthine oxidase-induced (but not saline-induced) decrease in lung compliance was relieved by superoxide dismutase. According to the present results xanthine oxidase induces a lung injury possible by production of free oxygen radicals. Superoxide dismutase can be valuable in prevention of free oxygen radical-mediated lung damage. Saline alone can be harmful when applied to the airways. This should be considered in clinical trials and in clinical practice.

Animals↗