Abstract

Very few measures actually can help the head injured patient. One of them is, the quality of intravenous fluid IVF. Glucose-saline (or dextrose-saline) of 5% and 0.9% (hyperosmolar 560 mOsm/L) in comparison with isotonic saline 0.9% (or physiologic saline osmolarity near 300 mOsm/L).

Method: Over 10 years of personal experience, we supply as a maintenance head injured patients (GCS below 12) with different types of intravenous fluids with close observation to the clinical outcome for the same groups of severity of injury, age and gender.

Results: Subjectively the ascent in GCS score is noticeable in all groups received glucose saline 5%, 0.9% compared to those supplied with isotonic saline 0.9%. While those who received glucose saline of isotonic strength with its different formulations had more prolonged recovery.

Conclusion: this good effect is due to hyperosmolarity which augment blood osmolality in face of disrupted blood brain barrier BBB Pharmacodynamically, it means it will not worsen brain edema if not improve it. Additionally, it also may be due to Insulin anabolic effect triggered by this extra glucose.