Hypertonic saline (HTS) in head injured patients - a multicentre, prehospital, prospective randomised clinical trial

头部损伤在严重创伤患者中很常见，其中许多是年轻人。颅脑损伤程度对患者预后有重要影响。创伤后低血压会在关键阶段减少脑供血，从而加重脑损伤的程度。这种继发性脑损伤大多发生在病人到达医院之前。高渗盐水（HTS）是一种静脉注射盐溶液，多年来一直用于重症监护患者，以减少颅脑损伤患者的脑肿胀。我们知道，HTS可以在患者到达医院之前给予，是安全的，并通过迅速提高血压和减少脑肿胀起作用。因此，HTS可以减少继发性脑损伤，提高生存率。重要的是，HTS可能会显著改善幸存者的神经功能，而没有任何显著的副作用风险。本研究旨在确定院前HTS在颅脑外伤伴外伤性昏迷和低血压患者中的有效性。

Head injury is common in patients with major trauma, many of whom are young adults. The extent of head injury has a major influence on patient outcome. Low blood pressure after trauma worsens the extent of brain injury by decreasing its blood supply at a critical stage. Much of this secondary brain injury occurs before the patient reaches hospital. Hypertonic saline (HTS) is an intravenous salt solution which has been used in intensive care patients for many years to decrease brain swelling in head injured patients. We know that HTS can be given to patients before they reach hospital, is safe, and acts by rapidly increasing blood pressure and decreasing brain swelling. Accordingly HTS may minimise secondary brain injury and lead to increased survival. Importantly, HTS is likely to dramatically improve neurological function of survivors without any significant risk of side effects. This study is designed to determine the effectiveness of prehospital HTS in head injured trauma patients with traumatic coma and low blood pressure.