Saline or Albumin for Fluid Resuscitation in Patients with Traumatic Brain Injury
The Saline versus Albumin Fluid Evaluation (SAFE) study had earlier suggested that patients with traumatic brain injury resuscitated with albumin had a higher mortality rate than those resuscitated with saline. A post hoc follow-up study of patients with traumatic brain injury who were enrolled in the study was published this week in NEJM.
460 patients, of whom 231 (50.2%) received albumin and 229 (49.8%) received saline were followed. The subgroup of patients with GCS scores of 3 to 8 were classified as having severe brain injury (160 [69.3%] in the albumin group and 158 [69.0%] in the saline group).
- At 24 months, 71 of 214 patients in the albumin group (33.2%) had died, as compared with 42 of 206 in the saline group (20.4%) (P=0.003)
- Among patients with severe brain injury, 61 of 146 patients in the albumin group (41.8%) died, as compared with 32 of 144 in the saline group (22.2%) (P<0.001)
- Among patients with GCS scores of 9 to 12, death occurred in 8 of 50 patients in the albumin group (16.0%) and 8 of 37 in the saline group (21.6%) (P=0.50).
Conclusions: In this post hoc study of critically ill patients with traumatic brain injury, fluid resuscitation with albumin was associated with higher mortality rates than was resuscitation with saline.
Reference: click to get abstract/article
Saline or Albumin for Fluid Resuscitation in Patients with Traumatic Brain Injury - The SAFE Study Investigators, Volume 357: 874-884 — August 30, 2007 — Number 9
