Evaluation of the various methods of fluid resuscitation in concussion and its relationship with patient outcomes

Abstract

Background: Various fluids such as saline, hypertonic saline, and serum colloid are used to compensate the body lost fluids after head trauma. The aim of this study was to determine the effects of various solutions on vital signs, serum electrolytes and acid-base status in patients with head trauma. Methods: This cross-sectional study was done in Alzahra hospital, Isfahan University of Medical Sciences, Iran. 340 hospital records of patients with head trauma were studied and hemodynamic parameters, blood gases and electrolytes were analyzed based on the osmolarity status. The data were analyzed using chi-square and one-way and repeated-measures analysis of variance (ANOVA) tests. Findings: During hospitalization in intensive care unit (ICU), 74 patients (21.8) died. Need to ventilation was different based on the kind of fluid and the percent of ventilation in hyperosmolar group (48.8) was lower significantly than the iso- (64.4) and hypo-osmolar (56.4) groups (P = 0.042). The mortality rate was significantly higher in iso-osmolar group (37.8) compared to hypo- (17.9) and hyperosmolar (15.6) groups (P < 0.001). Conclusion: Using hyperosmolar solutions in patients with head trauma led to more favorable hemodynamic stability and electrolyte status and lower mortality rates in these patients. So, using hyperosmolar solutions, if there is no contraindication, is preferred to hypo- and iso-smolar solutions and is recommended. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved.