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Hypertonic fluid therapy diminishes cerebral edema and enhances systemic perfusion pressure in patients with severe blunt head injury, but its effect on neurological outcome is unknown. In a multicenter, double-blind, randomized, placebo-controlled trial, researchers evaluated the effect of hypertonic fluid in patients >15 years who had sustained severe blunt closed head injury (prehospital Glasgow Coma Scale score <8) and did not have hypovolemic shock (systolic blood pressure ≤70 mm Hg or 71–90 mm Hg with a pulse ≥108 beats per minute). Patients were randomized to receive an initial fluid bolus of 250 mL of 7.5% saline, 7.5% saline/6% dextran 70, or 0.9% saline within 4 hours of the dispatch call.
Six-month outcome data were available for …