Effect Of Hyperosmolar 3,5% Nacl Solution On Cerebral Edema In Patients With Traumatic Brain Injury

In the structure of injuries, traumatic brain injury is the most dramatic. TBI remains one of the most important public health problems. Background: To study the effect of early administration of 3,5% HSS on systemic, central hemodynamics, hemostasis, ICP, CPP, efcacy and safety in isolated traumatic brain injury in an adult population. Material and methods: The study design was a retrospective - 16 patients and prospective 20-patient, single-center, randomized open clinical trial of 36 patients treated in intensive care unit (ICU) with isolated traumatic brain injury aged 18 to 88 years with depression of consciousness (4-12 Glasgow scale score), and abnormal head computed tomography fndings on admission. Daily data during 7 days after admission to the TBI included hourly measurements of ICP, recorded noninvasively using Complexmed 1.2, and if possible, by lumbar subarachnoid puncture with manometry in 9 patients, determination of serum sodium, pulse oximetry and measurements of daily diuresis, plasma osmolarity. Results: At 20-25 minutes after thebolus of 3,5% HSS injection, the ICP decreased (stage 2) below 20 mmHg, reaching an average of 19,7 mmHg, i.e. decreasing relative to the initial data by 26,3% (p<0,05). The maximum decrease of ICP was noted at the 3rd stage of the study (after 30 minutes), where, amounting to 18, 9 ± 0.73 mmHg, it was 29,3% (p<0,05) lower than the initial values. Conclusions: NaCl HSS can be used as early as possible in patients with traumatic brain injury and high risk of developing ICH.