Saline Reduces Mortality for Brain Injury Patients

It results in lower death rates compared to albumin fluid, study finds.

By Serena Gordon
HealthDay Reporter
Wednesday, August 29, 2007; 12:00 AM

Copyright © 2007 ScoutNews, LLC. All rights reserved.

WEDNESDAY, Aug. 28 (HealthDay News) -- A simple change in the way people with traumatic brain injuries are treated initially might make a big difference in their survival odds, a new Australian study suggests.

The study found that using saline rather than albumin fluid to maintain normal fluid volume levels in people with severe brain injuries resulted in nearly double the survival rate at 24 months after the injury.

"We determined that the 2-year mortality rate was significantly high in those patients who received albumin-based fluids compared to those who received saline, particularly those patients with severe brain injuries who presented with traumatic coma," said the study's lead author, Dr. John Myburgh, director of the division of critical care and trauma at the George Institute for International Health, in Sydney.

"Given the significant difference in mortality that we observed, we recommend that albumin-based fluids be avoided for the acute fluid resuscitation of patients with traumatic brain injury," added Myburgh, who's also a professor of critical care at the University of New South Wales.

Results of the study are published in the Aug. 30 issue of the New England Journal of Medicine.

Traumatic brain injury is caused by a sharp blow to the head that often occurs in falls, motor vehicle crashes or from physical assault, according to the U.S. Centers for Disease Control and Prevention. The CDC estimates that about 1.4 million traumatic brain injuries occur annually in the United States, and about 50,000 of those people die as a result of the injury each year. Those who survive may have lifelong disabilities.

Some of the most serious damage to the brain occurs at the time of the injury, and soon after, when the brain swells in response to the injury. Because the brain is an enclosed system, if swelling occurs, brain tissue becomes damaged.

Fluid resuscitation is a common part of traumatic brain injury treatment to ensure normal blood circulation in the brain, according to the study. However, there's been some debate as to what type of fluid would most benefit people with traumatic brain injuries -- saline or albumin fluid. Albumin is the main protein component of human blood.