2026-04-17T19:20:55Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/137872025-10-24T08:53:21Zcom_2072_378070com_2072_378040com_2072_378071col_2072_378092col_2072_378097

Re-evaluating albumin use in traumatic brain injury Vincent, Jean-Louis Wiedermann, Christian Josef Reinstrup, Peter Ferrer, Ricard Taccone, Fabio Silvio 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 Albumin; Intracranial pressure; Outcomes Albúmina; Presión intracraneal; Resultados Albúmina; Pressió intracranial; Resultats Traumatic 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. 2025-10-24T08:53:21Z 2025-10-24T08:53:21Z 2025-10-24T08:53:21Z 2025-10-06T09:50:28Z 2025-10-06T09:50:28Z 2025-08-01 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/13787 Journal of Intensive Care;13(1) https://doi.org/10.1186/s40560-025-00813-y Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess BMC Scientia