2026-04-13T01:47:32Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/137872025-10-24T08:53:21Zcom_2072_378070com_2072_378040com_2072_378071col_2072_378092col_2072_378097
RECERCAT
author
Vincent, Jean-Louis
author
Wiedermann, Christian Josef
author
Reinstrup, Peter
author
Ferrer, Ricard
author
Taccone, Fabio Silvio
2025-10-24T08:53:21Z
2025-10-24T08:53:21Z
2025-10-06T09:50:28Z2025-10-06T09:50:28Z2025-08-01
http://hdl.handle.net/11351/13787
Albumin; Intracranial pressure; OutcomesAlbúmina; Presión intracraneal; ResultadosAlbúmina; Pressió intracranial; ResultatsTraumatic brain injury (TBI) affects approximately 69 million people annually, with the majority of cases being mild-to-moderate in severity. However, in severe TBI, early management is critical and includes fluid resuscitation to control intracranial pressure (ICP) and optimize cerebral perfusion pressure. The SAFE-TBI study linked hypotonic 4% albumin to higher mortality versus saline (33.2% vs. 20.4%; RR 1.63; P = 0.003), likely due to elevated ICP, prompting guidelines favoring saline. However, these recommendations are based on low-quality evidence and overlook hyperoncotic albumin. Preclinical data confirm that hypotonicity—not albumin—drives ICP elevation. Emerging data suggest that hyperoncotic albumin (20–25%) may reduce ICP and improve outcomes. This letter highlights evidence gaps and advocates re-evaluating albumin use in TBI, especially hyperoncotic formulations.This publication was supported by Grifols.
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Dany cerebral - Tractament
Cap - Ferides i lesions - Tractament
Albúmina - Ús terapèutic
Fluidoteràpia
DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Brain Injuries::Brain Injuries, Traumatic
Other subheadings::Other subheadings::/therapy
ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Drug Therapy::Fluid Therapy
CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Albumins
Other subheadings::Other subheadings::/therapeutic use
ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::lesiones encefálicas::lesiones encefálicas traumáticas
Otros calificadores::Otros calificadores::/terapia
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::farmacoterapia::fluidoterapia
COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::albúminas
Otros calificadores::Otros calificadores::/uso terapéutico
Re-evaluating albumin use in traumatic brain injury
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion