J.Jpn. Surg. Soc.. 80(4): 357-364, 1979
Original article
CLINICAL APPLICATION OF HLS IN SEVERE HEAD INJURY
－ASSESSMENT OF LONG TERM OUTCOME USING GLASGOW COMA SCALE AND OUTCOME SCALE－
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*) Trauma Intensive Care Unit, Osaka University Hospital Yusuke SAWADA*), Toshiharu YOSHIOKA*), Tsuyushi SUGIMOTO*), Shuji SHIMAZAKI**) |
Coping with these great problems, we have applied HLS (Hypertonic Lactated Saline) solution as an initial infusion for those cases to prevent edema and to decrease intracranial pressure. In an attempt to determine the long term result of HLS solution, we did a randomized study between 1974 and 1978. On 279 adult patients with severe head injury, 147 of which were treated with HLS and 132 without HLS.
Follow-up study shows marked differences on (1) mortality (2) mortality from brain death and (3) late outcome between HLS and Control groups. All patients were graded using the Glasgow Coma Scale. The mortality rate decreased from 70.8% to 56.7%. The incidence of brain death also became lower from 76.1% to 60.0%. In Control group, 17.7% made a good recovery or moderate disability. On the other hand, 27.7% of them made that in HLS group.
HLS solusion brings the hypertonic diuretic effects and lowers the intracranial pressure continuously, so that the cerebral circulation is maintained sufficiently. It maintaines adepuate extracellular fluid as its expander and it is not associated with loss of renal function.
Thus, we concluded that HLS solution is an excellent initial infusion in terms of late result for the patients with severe head injury.
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