A Trial of Continuous Hypertonic Saline Infusion in Traumatic Brain Injury

Hypertonic saline infusion is often used to prevent intracranial hypertension in patients with traumatic brain injury (TBI), but relatively limited data are available to support this practice. The current randomized clinical trial tested the hypothesis that protocolized continuous infusion of 20% hypertonic saline would improve neurologic outcome at 6 months, measured by the Glasgow Outcome Scale–Extended (GOS-E). Important secondary outcomes included mortality and the occurrence of intracranial pressure (ICP) elevation. Participating sites were nine university hospitals in France. Eligible patients were aged 18 to 80 with moderate or severe TBI, enrolled within 24 hours after trauma. The intervention consisted of an initial 1-hour bolus fo…