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

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.

This cross-sectional study examined 358 traumatic brain injury patients admitted to the emergency department of a hospital in Mashhad from June 2018 to June 2021. 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.

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 16, 1-2L normal saline was associated with shorter hospital stays than >2L fluids. Pre-hospital transport times < 15 minutes were correlated with lower mortality and shorter hospitalizations versus > 15 minutes.

Fluid volume impacts outcomes in traumatic brain injury. In hypotensive or severely injured patients (ISS>16), 1-2L normal saline was linked to shorter hospital stays versus >2L fluid volumes. The type of crystalloid did not affect outcomes in normotensive patients. Minimizing pre-hospital transport times below 15 minutes may improve patient survival and recovery. Optimizing fluid resuscitation protocols has the potential to improve traumatic brain injury prognosis.