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01-12-2024 | Central Nervous System Trauma | Research

Effect of continuous hypertonic saline infusion on clinical outcomes in patients with traumatic brain injury

Authors: Chi Peng, Lijie Chi, Mengjie Chen, Liwei Peng, Fan Yang, Liangjing Shao, Lulong Bo, Zhichao Jin

Published in: Neurosurgical Review | Issue 1/2024

Abstract

Osmotic therapy has been recognized as an important treatment option for patients with traumatic brain injury (TBI). Nevertheless, the effect of hypertonic saline (HTS) remains unknown, as findings are primarily based on a large database. This study aimed to elucidate the effect of HTS on the clinical outcomes of patients with TBI admitted to the intensive care unit (ICU). We retrospectively identified patients with moderate-to-severe TBI from two public databases: Medical Information Mart for Intensive Care (MIMIC)-IV and eICU Collaborative Research Database (eICU-CRD). A marginal structural Cox model (MSCM) was used, with time-dependent variates designed to reflect exposure over time during ICU stay. Trajectory modeling based on the intracranial pressure evolution pattern allowed for the identification of subgroups. Overall, 130 (6.65%) of 1955 eligible patients underwent HTS. MSCM indicated that the HTS significantly associated with higher infection complications (e.g., urinary tract infection (HR 1.88, 95% CI 1.26–2.81, p = 0.002)) and increased ICU LOS (HR 2.02, 95% CI 1.71–2.40, p < 0.001). A protective effect of HTS on GCS was found in subgroups with medium and low intracranial pressure. Our study revealed no significant difference in mortality between patients who underwent HTS and those who did not. Increased occurrence rates of infection and electrolyte imbalance are inevitable outcomes of continuous HTS infusion. Although the study suggests slight beneficial effects, including better neurological outcomes, these results warrant further validation.

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Title: Effect of continuous hypertonic saline infusion on clinical outcomes in patients with traumatic brain injury
Authors: Chi Peng
Lijie Chi
Mengjie Chen
Liwei Peng
Fan Yang
Liangjing Shao
Lulong Bo
Zhichao Jin
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Central Nervous System Trauma
Intracranial Hypertension
Hypernatremia
Published in: Neurosurgical Review / Issue 1/2024
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-024-02316-0

2024 ASCO Annual Meeting

Springer Medicine

Effect of continuous hypertonic saline infusion on clinical outcomes in patients with traumatic brain injury

Abstract

2024 ASCO Annual Meeting

Springer Medicine

Abstract

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