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Risk of Death Higher After Albumin for Brain Injury

Lower risk with saline resuscitation

WEDNESDAY, Aug. 29 (HealthDay News) -- Resuscitating traumatic brain injury patients with albumin instead of saline can increase the risk of death by nearly twofold, according to study findings published in the Aug. 30 issue of the New England Journal of Medicine.

John Myburgh, M.D., Ph.D., from ANZICS Clinical Trials Group in Carlton, Victoria, Australia, and colleagues randomized 460 patients with traumatic brain injury to resuscitation with albumin or saline. The 318 patients with Glasgow Coma Scale (GCS) scores of 3-8 were classified as having severe brain injury.

After 24 months, the researchers found that significantly more patients in the albumin group died (33.2 versus 20.4 percent, relative risk 1.63). Similar results were observed in patients with severe brain injury (41.8 versus 22.2 percent, relative risk 1.88). Fewer patients with a GCS score of 9-12 treated with albumin died (16 versus 21.6 percent, relative risk 0.74), though this was not statistically significant.

"In this post-hoc study of critically ill patients with traumatic brain injury, fluid resuscitation with albumin was associated with higher mortality rates than was resuscitation with saline," Myburgh and colleagues conclude.

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