Comparison of normal saline and balanced salt solution as maintenance fluid on acid-base and electrolyte status in traumatic brain injury patients - a prospective randomized double blind study

The study will be conducted in ICU of trauma centre, department of anaesthesiology, IMS, BHU Varanasi after written informed consent and institutional ethical approval. After CTRI registration, 100 patients of isolated nonoperative head injury, age 18 to 60 years admitted to trauma ICU within 24hr of injury will be included. Patient will be excluded from study if baseline electrolyte are outside normal range, on ionotropic support, having systemic illness like diabetes, hypertention, patient with end organ damage, polytrauma patients and patient refusal. Patient will be divided randomly using computer generated number and concealed using sequentially numbered, sealed opaque enevelop technique into two equal groups-

Group N: will receive normal saline as maintenance fluid

Group B: will receive balanced crystalloids as maintenance fluid

All patients will follow the ICU protocol for head injury management. A drug which affects the fluid and electrolyte status like mannitol, Diuretics etc will be recorded in both groups. Acid base status & electrolyle will be recorded on day1 , 3, 5, 7, 14 and on every 5 days there after till icu stay.

Result

Acid base status and electrolyte levels are better maintained in balanced crystalloid groups than normal saline and his was  statically significant on day 14. No significant difference in 28 days mortality between two groups.

Conclusion

Balanced craystalloids  can be used in traumatic brain injury patients. Further large multicentric study required to evaluate their effects on intracranial pressure.