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Thu Apr 27 19:26:43 BST 2006

I don't think your missing anything.  IMHO, the definitive study that
answers ANY question in TBI probably doesn't exist.  The Brain Trauma
Foundation guidelines (2nd ed) are a good summary of current evidence
which neither supports or repudiates HTS in the setting of TBI.  A 3rd
edition should be coming out shortly.  

http://www2.braintrauma.org/guidelines/downloads/btf_guidelines_manageme
nt.pdf?BrainTrauma_Session=4df986d7bb31df66cb8580d60771d6e4 

Scott Gunn, MD 
Medical Director, Surgical Trauma Intensive Care Unit
Department of Critical Care Medicine
University of Pittsburgh Medical Center

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Ronald Gross
Sent: Thursday, April 27, 2006 1:36 PM
To: trauma-list at trauma.org
Subject: Re: Hypertonic saline

Tom, Mike, et al,

Is this HTS for TBI the new "steroid for SCI" debate?  I had looked at a
lot of the "recent" literature, and asked our neurosurgical colleagues,
when I could find them  ;-)  (settle down, y'all, JUST
KIDDING!!) and no one has been able to give me that ONE prospective
study that proves that HTS absolutely works.

Have I missed something?  Don't mean to sounb really dumb, but I am
feeling that way right about now.....

Ron

>>> Tom Hurst <tom at veldt.demon.co.uk> 04/27 1:30 PM >>>
Wade C: Meta-analysis of Hypertonic saline in Traumatic
Hypotension: Acta Anaes Scand 1997, 77-79

I *think* this is the paper that suggested an improvement in hypotensive
patients with TBI.

Regards

Dr. Tom Hurst
Specialist Registrar - Anaesthesia
UK

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Hypertonic saline