Introduction: 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.
Methods: 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.
Results: 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.
Conclusion: 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.