Fluid Therapy in Fluid Resuscitation of Patients with Traumatic Brain Injury: A Retrospective Cohort Study

Introduction: Traumatic brain injury (TBI) represents a critical medical condition imposing a substantial disease burden globally. Appropriate fluid resuscitation is essential for trauma recovery. This study evaluated optimal fluid strategies for TBI patients.Methods: This cross-sectional study examined ۳۵۸ traumatic brain injury patients admitted to the emergency department of a hospital in Mashhad from June ۲۰۱۸ to June ۲۰۲۱. Patients were categorized into four groups per total pre-hospital fluid volume received, five groups per fluid type received, and three groups per pre-hospital transport times. Variables, such as the Glasgow Coma Scale (GCS), blood pressure, mortality, and morbidity, were recorded.Results: In patients with normal blood pressure, there was no difference in outcomes between normal saline versus balanced crystalloids. In hypotensive or severely injured patients with injury severity scores greater than ۱۶, ۱-۲L normal saline was associated with shorter hospital stays than >۲L fluids. Pre-hospital transport times < ۱۵ minutes were correlated with lower mortality and shorter hospitalizations versus > ۱۵ minutes.Conclusion: Fluid volume impacts outcomes in traumatic brain injury. In hypotensive or severely injured patients (ISS>۱۶), ۱-۲L normal saline was linked to shorter hospital stays versus >۲L fluid volumes. The type of crystalloid did not affect outcomes in normotensive patients. Minimizing pre-hospital transport times below ۱۵ minutes may improve patient survival and recovery. Optimizing fluid resuscitation protocols has the potential to improve traumatic brain injury prognosis.

کلیدواژه ها:

Trauma ، Traumatic Brain Injury ، Fluid Therapy ، Fluid resuscitation