Hypertonic Fluids Don’t Help Most Traumatic Brain Injuries

Traumatic brain injury is the most common cause of death in those who have had blunt-force trauma to the head. Survivors generally undergo severe, long-term disabilities and may even suffer secondary injuries because of intracranial pressure and decreased blood flow.

A new study examining out-of-hospital treatment with hypertonic fluids (electrolytes) has found that giving electrolyte treatments after severe traumatic brain injuries does not improve the outcome of the patient’s health.

The study is one of many over the last few years that look at potential treatments to stop the progression of brain injury. Researchers hope to find a treatment that serves as a “neuroprotectant,” helping to protect brain cells from dying after an injury. To date, anti-oxidants and magnesium treatments have been disappointing.[1]

The Treatment

The electrolyte treatment contains hypertonic fluid, a saline mixture that is made of a high concentration of certain electrolytes. It has been known to improve blood flow to the brain, as well as help reduce the intracranial pressure that can follow brain injury.

Hypertonic fluids have also been used to restore appropriate levels of pressure within the brain and to limit swelling. The fluids may also lessen the body’s inflammatory response, reducing injury to neurons in the brain. Researchers thought that the benefits of hypertonic fluids should slow the progression of brain injury. Unfortunately, studies with high concentrations of electrolyte showed no improvement in patients.

The Findings

While previous research found that administering electrolyte fluids soon after brain injury could improve a patient’s chance of survival, larger studies have not shown findings to support the smaller studies.

The most current experiment looked at 1,282 patients who suffered severe traumatic brain injuries. It is important to understand that these patients did not have the complication of shock caused by blood loss from the injury. In this group of patients, some received a single dose of hypertonic fluids before they arrived at the hospital. Others received one dose of a normal saline solution.[2]

Researchers found that after six months, the patients in both groups had similar survival and disability rates. They concluded that giving electrolyte treatments did not cause notable changes in outcomes. The patients who received electrolytes fared no better than those who were given saline.

Hospital Intervention

According to Dr. Mayer and University of Washington Professor Eileen M. Bulger, researchers who conducted the study, hypertonic fluids may still play a role for brain-injured patients with high intracranial pressure. While the effect of the treatment has not demonstrated an improvement, intracranial pressure can be deadly. Hospitals must still use every tool available to control intracranial pressure. This might mean giving hypertonic fluids, despite the findings of this study.

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If you or someone you know has suffered a traumatic brain injury, contact our attorneys. Not only will they will provide you with a free consultation of your case, but they will also work with you to secure any financial compensation you are owed for past or future medical bills, as well as for any pain or suffering you may be experiencing.


[1] http://online.wsj.com/article/SB10001424052748703298504575534362216876780/?mod=ITP_pageone_1
[2] http://jama.ama-assn.org/cgi/content/abstract/304/13/1455

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