Hypertonk/Hyperoncotic Saline Reliably Reduces ICP in Severely Head-Injured Patients with Intracranial Hypertension

Hypertonic saline (HS) has been shown to decrease intracranial pressure (ICP) and cerebral water content in experimental models of traumatic brain injury (TBI). The purpose of the present study was to test the efficacy of administration of HS (7,5%) combined with 6% hydroxyethyl starch (molecular weight 200.000/0.60–0.66; HHES) for the treatment of therapy-resistant intracranial hypertension in patients with severe TBI. Six patients with severe TBI (GCS 25 mmHg, cerebral perfusion pressure (CPP) 4 hours since the last HS/HHES treatment) were prospectively enrolled in the study and received between one and ten bolus infusions of maximal 250 ml HS/HHES at a rate of 20 ml/min. A total of 32 infusions were given.