Effect of Continuous Infusion of Hypertonic Saline vs. Standard Care in Patients With TBI

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Among patients with moderate to severe traumatic brain injury (TBI), treatment with continuous infusion of 20% hypertonic saline compared with standard care did not result in a significantly better neurological status at 6 months. However, confidence intervals for the findings were wide, and the study may have had limited power to detect a clinically important difference.

Among 370 patients who were randomized, 359 (97%) completed the trial. The adjusted common OR for the GOS-E score at 6 months was 1.02.

Of the 12 secondary outcomes, 10 were not significantly different.

Intracranial hypertension developed in 62 (33.7%) patients in the intervention group and 66 (36.3%) patients in the control group.

The primary outcome was Extended Glasgow Outcome Scale (GOS-E) score (range, 1-8, with lower scores indicating worse functional outcome) at 6 months, obtained centrally by blinded assessors and analyzed with ordinal logistic regression adjusted for prespecified prognostic factors (with a common odds ratio [OR] >1.0 favoring intervention).

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