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June 23/30, 2004

Hypertonic Saline for Prehospital Treatment of Traumatic Brain Injury

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(24):2943-2944. doi:10.1001/jama.291.24.2944-a

To the Editor: I have 2 concerns about the study by Dr Cooper and colleagues.1

First, it is unclear whether the 2 groups were comparable in terms of their pattern of injury and severity. Some patients probably had major abdominal organ injuries; such patients were apparently hypotensive for an extended period of time. This could lead to a protracted period of splanchnic hypoperfusion, which is a potent trigger of posttraumatic cascade responses and, thus, a potential confounder.

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