Recently the Neurosurgery department at our hospital has questioned the use of 3% hypertonic saline given in the ED for traumatic brain injury when clinically indicated.
They site a lack of great data supporting improved mortality when given in the ED.
To me there are not enough studies, looking at both mortality and morbidity, to not give it a shot in these critically injured kids.
Despite the lack of great evidence I wanted to see what is being done around the country.
1- Do you know of additional studies citing the use of 3% HTS in TBI.
2- Is anyone still using Mannitol?
3- Do you have a protocol in place for when to use 3% HTS in TBI.
4- If a protocol is in place, who is involved?(Neurosurgery, critical care, etc)
Thanks for your input!
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