In clinical trial, patients with severe injuries will randomly receive a stronger saline solution

Portland area victims of shock and severe head injury will not only be treated by emergency personnel starting Nov. 1, but they will also be participating in a widespread clinical trial, whether they know it or not.

Oregon Health and Science University researchers received final approval last week to begin testing a new intravenous saline solution on trauma victims. OHSU is one of 11 regional medical centers across the country participating in the test.

Researchers believe that a saline solution containing a higher concentration of salt than the traditional IV saline solution may keep a greater percentage of trauma victims alive. But they have no way to test the new solution in a controlled setting with patients giving their consent to the new solution, because trauma cases occur outside the hospital, and emergency personnel don't have the time to go through a consent process on site.

"When time is short, when someone's life is in the balance, the process of getting consent cannot be followed because of the risk to the patient," said Jerris Hedges, OHSU's principal investigator for the trial. OHSU has undertaken a community education program to tell people about the trial and give them the option of wearing a bracelet that will tell emergency personnel they want only the traditional saline solution if they are treated.

Everyone else will randomly receive either the traditional solution or the experimental one, which researchers hope will reduce the fatality rate among victims of shock and head trauma. Currently, according to Hedges, about three in 10 shock and head trauma victims die. The new solution is intended to allow better blood flow to the brains of trauma victims, thus reducing swelling and brain injury.

Hedges said he thinks the new solution may cut the fatality rate by 10 percent.

"We need to keep their body working at a better state than where they are now," Hedge said.

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