Re-evaluating albumin use in traumatic brain injury

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 p...

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Autores: Vincent, Jean-Louis|||0000-0001-6011-6951, Ferrer, Ricard|||0000-0002-4859-4747, Taccone, Fabio Silvio, Wiedermann, Christian J., Reinstrup, Peter
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:322304
Acceso en línea:https://ddd.uab.cat/record/322304
https://dx.doi.org/urn:doi:10.1186/s40560-025-00813-y
Access Level:acceso abierto
Palabra clave:Albumin
Traumatic brain injury
Intracranial pressure
Outcomes
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spelling Re-evaluating albumin use in traumatic brain injuryVincent, Jean-Louis|||0000-0001-6011-6951Ferrer, Ricard|||0000-0002-4859-4747Taccone, Fabio SilvioWiedermann, Christian J.Reinstrup, PeterAlbuminTraumatic brain injuryIntracranial pressureOutcomesTraumatic 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. 22025-01-0120252025-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/322304https://dx.doi.org/urn:doi:10.1186/s40560-025-00813-yreponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3223042026-06-06T12:50:31Z
dc.title.none.fl_str_mv Re-evaluating albumin use in traumatic brain injury
title Re-evaluating albumin use in traumatic brain injury
spellingShingle Re-evaluating albumin use in traumatic brain injury
Vincent, Jean-Louis|||0000-0001-6011-6951
Albumin
Traumatic brain injury
Intracranial pressure
Outcomes
title_short Re-evaluating albumin use in traumatic brain injury
title_full Re-evaluating albumin use in traumatic brain injury
title_fullStr Re-evaluating albumin use in traumatic brain injury
title_full_unstemmed Re-evaluating albumin use in traumatic brain injury
title_sort Re-evaluating albumin use in traumatic brain injury
dc.creator.none.fl_str_mv Vincent, Jean-Louis|||0000-0001-6011-6951
Ferrer, Ricard|||0000-0002-4859-4747
Taccone, Fabio Silvio
Wiedermann, Christian J.
Reinstrup, Peter
author Vincent, Jean-Louis|||0000-0001-6011-6951
author_facet Vincent, Jean-Louis|||0000-0001-6011-6951
Ferrer, Ricard|||0000-0002-4859-4747
Taccone, Fabio Silvio
Wiedermann, Christian J.
Reinstrup, Peter
author_role author
author2 Ferrer, Ricard|||0000-0002-4859-4747
Taccone, Fabio Silvio
Wiedermann, Christian J.
Reinstrup, Peter
author2_role author
author
author
author
dc.subject.none.fl_str_mv Albumin
Traumatic brain injury
Intracranial pressure
Outcomes
topic Albumin
Traumatic brain injury
Intracranial pressure
Outcomes
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2
2025-01-01
2025
2025-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/322304
https://dx.doi.org/urn:doi:10.1186/s40560-025-00813-y
url https://ddd.uab.cat/record/322304
https://dx.doi.org/urn:doi:10.1186/s40560-025-00813-y
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
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dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
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eu_rights_str_mv openAccess
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dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
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