Trauma – Doctors want to test hypertonic saline on accident victims in Portland and other cities
Name : ANDY DWORKIN
Doctors hope that the traumatic accidents of thousands in Oregon and nationwide will answer a vexing question: How to best help people who have lost lots of blood?
They think the answer may be using a highly concentrated saline solution in place of the less-salty liquid that trauma victims now get outside the hospital.
They plan to test the idea on people suffering severe brain injury or shock from blood loss in Portland and 10 other U.S. and Canadian cities.
Such people can’t consent to usual scientific trials. So researchers hope to use a federal waiver that substitutes a community education process for individual informed consent. The researchers are holding community meetings this week and next as part of this effort to get the trial running in Portland by summer.
Finding a better blood replacement has been the holy grail of trauma medicine for years, said Dr. Mohamud Daya, one of several Oregon Health & Science University researchers leading Portland’s effort to join the trial.
Solution in the field
For practical reasons, medics can’t give donated blood at trauma scenes. Blood is too fragile to carry on ambulances. And it’s hard to match donor and patient blood types at a trauma scene.
So emergency medical technicians in the field give trauma victims “normal saline” to increase their fluid level and spread oxygen in the body. That solution has less than 1 percent saline, about as salty as blood or tears. It keeps some people alive until they reach the hospital, but many people still die.
A few small studies in animals and people suggest that concentrated saline may be better than normal saline in several ways:
Some of the normal saline infused seeps out of vessels into other body tissues. So adding a quart of saline effectively boosts circulating blood by a cup. Hypertonic saline is so salty it draws fluids from other tissues into the bloodstream. A cup of hypertonic saline boosts blood volume by a quart, Daya said.