Journal article

Albumin Resuscitation for Traumatic Brain Injury: Is Intracranial Hypertension the Cause of Increased Mortality?

D James Cooper, John Myburgh, Stephane Heritier, Simon Finfer, Rinaldo Bellomo, Laurent Billot, Lynette Murray, Shirley Vallance

JOURNAL OF NEUROTRAUMA | MARY ANN LIEBERT, INC | Published : 2013

Abstract

Mortality is higher in patients with traumatic brain injury (TBI) resuscitated with albumin compared with saline, but the mechanism for increased mortality is unknown. In patients from the Saline vs. Albumin Fluid Evaluation (SAFE) study with TBI who underwent intracranial pressure (ICP) monitoring, interventional data were collected from randomization to day 14 to determine changes in ICP (primary outcome) and in therapies used to treat increased ICP. Pattern mixture modelling, designed to address informative dropouts, was used to compare temporal changes between the albumin and saline groups, and 321 patients were identified, of whom 164 (51.1%) received albumin and 157 (48.9%) received sa..

View full abstract

Grants

Awarded by Victorian Neurotrauma Initiative, Australia


Awarded by National Health and Medical Research Council of Australia


Funding Acknowledgements

This study was funded by a project grant (number DP016) from the Victorian Neurotrauma Initiative (grant number DP016), Australia. Associate Professor Heritier is supported by a program grant (number 57281) from the National Health and Medical Research Council of Australia. Statistical analysis was partially funded by the Division of Critical Care and Trauma of the George Institute for Global Health, Sydney, Australia. The Management Committee consisted of D James Cooper, (co-chair), John Myburgh, (co-chair), Michael Bailey, Rinaldo Bellomo, Laurent Billot, Simon Finfer, Parisa Glass, Stephane Heritier, Michael Fitzharris, Alisa Higgins, Daryl Jones, Siouxzy Morrison, Lynette Murray, Alistair Nichol, Gillian Syres, and Shirley Vallance. Associate Professor Michael Bailey assisted with the initial statistical analyses. Associate Professor Dinesh Varma, Alfred Hospital, Melbourne conducted the blind review of cranial CT scans. The Site investigators (Australia unless stated) were Alfred Hospital, Melbourne: D James Cooper, and Shirley Vallance; Austin Hospital, Melbourne: Rinaldo Bellomo, and Donna Goldsmith; Australian and New Zealand Research Centre, Melbourne: Michael Bailey, Rinaldo Bellomo, D James Cooper, Andrew Forbes, Alisa Higgins, Daryl Jones, Siouxzy Morrison, Lynette Murray, Alistair Nichol, and Gillian Syres; Royal Darwin Hospital: Diane Stephens, and Jane Thomas; Fremantle Hospital: David Blythe, and Anna Palermo; John Hunter Hospital, Newcastle: Peter Harrigan, Brett McFadyen, and Agness Tembo; George Institute for Global Health, Sydney: Laurent Billot, Simon Finfer, Michael Fitzharris, Parisa Glass, Stephane Heritier, Serigne Lo, Mathieu Rose, and John Myburgh; Middlemore Hospital, New Zealand: Judy Tai, and Anthony Williams; Nepean Hospital, Sydney: Louise Cole, Iveta Nalos, Ian Seppelt, and Leonie Weisbrodt; Princess Alexandra Hospital, Brisbane: Sally Gipps, Chris Joyce, Ben Mackie, and Bala Venkatesh; Royal Adelaide Hospital: Marianne Chapman, Stephanie O'Connor, and Justine Rivett; Royal Hobart Hospital: Anthony Bell, Kathryn Marsden, and Andrew Turner; Royal Melbourne Hospital: Deborah Barge, Jack Cade, Tania Caf, and Megan Robertson; Royal North Shore Hospital, Sydney: Simon Finfer, Anne O'Connor, Julie Potter, and Naresh Ramakrishnan; St George Hospital, Sydney: Vanessa Dhiacou, Alina Jovanovska, and John Myburgh.Professor Cooper has no competing financial interests in relation to this study. Professor Myburgh has no competing financial interests exist in relation to this study. In relation to ongoing fluid resuscitation research, The George Institute for Global Health and the University of Sydney have received a speaker's fee, unrestricted research grant support, and refund of travel expenses incurred on Professor Myburgh's behalf from Fresenius Kabi. Associate Professor Heritier has no competing financial interests in relation to this study. Professor Finfer has no competing financial interests in relation to this study. The SAFE Study was partially funded by CSL Limited. CSL Limited paid travel expenses for Professor Finfer to present results of the SAFE Study at scientific and industry-sponsored meetings. In relation to ongoing fluid resuscitation research, The George Institute for Global Health and the University of Sydney have received unrestricted research grant support and refund of travel expenses incurred on Professor Finfer's behalf from Fresenius Kabi. Professor Bellomo has no competing financial interests in relation to this study. The SAFE Study was part funded by CSL Limited. CSL Limited paid travel expenses for Professor Bellomo to present results of the SAFE Study at scientific and industry-sponsored meetings. Laurent Billot has no competing financial interests in relation to this study. Lynette Murray has no competing financial interests in relation to this study. Shirley Vallance has no competing financial interests in relation to this study.