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An additional analysis of 460 patients with traumatic brain injury from the SAFE study (the SAFE-TBI study) demonstrated that resuscitation with albumin was associated with significantly higher two-year mortality compared to saline (33.2% versus 20.4%, relative risk (RR) 1.63, 95% confidence intervals (CI) 1.17 to 2.26, p = 0.003) [ 6].
SAFE-TBI is a well done post-hoc analysis.
The findings of SAFE-TBI are another important addition to the unfavorable existing literature concerning the superiority of colloid over crystalloid.
Clinical uncertainty about the efficacy of its use remains, apart from patients with traumatic brain injury where, on the basis of the SAFE-TBI study, use of albumin for resuscitation is contraindicated [ 6].
To determine the potential significance of this finding, the SAFE study investigators undertook this post-hoc analysis (SAFE-TBI) [ 1], which included obtaining relevant baseline characteristics from case report forms, clinical records, and CT scans, and a determination of vital status and functional neurologic outcomes 243 months after randomization.
Based on the results of SAFE-TBI and other studies, the Cochrane group concluded that there is no evidence from randomized controlled trials in critically ill or trauma patients that resuscitation with colloids compared to crystalloids reduces the risk of death [ 4].
Wright and colleagues used intravenous progesterone at a dose of 0.71 mg/kg, followed by 0.5 mg/kg progesterone per 12 hours during the 3 following days, which appeared safe in the treatment of TBI patients [ 19].
Safe trip.
These results provided the preclinical proof-of-concept that CD19L sTRAIL plus low dose TBI would be a safe and effective treatment modality for the treatment of relapsed BPL.
Our study provides the preclinical proof-of-concept that the C61-LNP plus low dose TBI would be a safe and effective treatment modality for the treatment of relapsed BPL.
However, before a higher glutamine dose can be considered safe in patients suffering from severe TBI, a glutamine-dependent increase in cerebral glutamate and signs of cerebral impairment must be excluded during prolonged infusion of a higher glutamine dose.
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