A study has found that hypertonic fluid, a concentrated saline solution that paramedics administer intravenously to  head trauma patients, doesn’t help improve the patients’ chances of survival or their later brain function, according to a story in The Wall Street Journal Wednesday.

http://online.wsj.com/article/SB10001424052748703298504575534362216876780.html?mod=ITP_pageone_1

 The story, headlined “Saline Fluid Fails in Brain Therapy,” reports that a study released this week found that hypertonic fluid is not effective in the treatment of blunt traumatic brain injuries. That makes the saline solution the latest treatment, following anti-oxidants and intravenous magnesium, to flunk tests gauging their ability to help brain-trauma victims.

It has been believed that hypertonic fluid improves the blood flow in the brain while also decreasing intercranial pressure, and both those effects aid brain injury victims.  

The hypertonic fluid study, published in this week’s Journal of the American Medical Association ( JAMA), involved 1,282 patients treated by paramedics. The patients were either given regular saline solution or the hypertonic variety, which has eight times as much salt as the regular saline, according to The Journal.      

http://jama.ama-assn.org/cgi/content/abstract/304/13/1455

 The study’s authors, who included University of Washington surgery professor Eileen Bulger, said they couldn’t see any improvement in the six-month neurological outcome of the patients who received the hypertonic solution, according to The Journal. 

The study’s authors also wrote that there was “no compelling reason” to use “hypertonic fluid resuscitation for TBI in the out-of-hospital setting.”

The Journal Wednesday also noted that the U.S. Department of Defense has awarded $26.3 million to Banyan Biomarkers Inc. of Alachua, Fla. The military wants Banyan to devise a blood test to determine “the presence and severity of brain injury,” the newspaper reported. Biomarkers are proteins that an injured brain produces.

In the combat arena, the biomarker test would let the military immediately identify who has suffered brain injury in a bomb blast, and get them off the battlefield for treatment.      

http://www.army.mil/-news/2010/07/28/42934-army-health-promotion-risk-reduction-and-suicide-prevention-report/index.html

The startling report found that increased drug and alcohol abuse among soldiers is contributing to a skyrocketing suicide rate for service members, as well as leading to accidental deaths caused by risky behavior by the drunk and stoned.

http://www.aolnews.com/nation/article/army-report-finds-alarming-rise-in-suicides-risky-behavior/19573590

In fact, the report says that more soldiers die from their own actions rather than being killed by the enemy in combat.

“Simply stated, we are often more dangerous to ourselves than the enemy,” according to the Health Promotion, Risk Reduction and Suicide Prevention Report.

The report found that during the last fiscal year, 239 soldiers committed suicide, with more than 1,700 attempting to take their lives during that same period.  So-called high-risk behavior, like drinking and drug abuse, are contributing to the increased suicide numbers. 

But the report also said that a breakdown in leadership, in oversight over soldiers, can also be blamed for the deaths.

The report is based on a 15-month study, prompted by the rise in soldier suicides. At one time, the military had a lower suicide rate than the overall U.S. population. But that trend started to change in 2004, according to the report, and in 2008 the Army’s suicide rate was higher than Americans overall.

I have written about the mental and physical impact of repeated deployments of our troops in Iraq and Afganistan. I have written  how the military seems to be putting its head in the sand about the brain injury that these soldiers sustain, by not doing the mandated testing when soldiers have completed their tours.

Brain injury, mild or severe, often leads to depression. And clinical depression, if not treated properly, often leads to self-medication, with illegal drugs or alchohol. And clinical depression can lead to suicide. That is part of the big picture here.

Ike Skelton, D-Mo., is chairman of the House Armed Service Committee. He issued a statement about the Army’s report — or should be.

“It’s clear that the Army feels the same heartache that all Americans feel when even one service member takes his or her life, and the Army deserves praise for its honest and comprehensive study on suicide prevention,” Skelton said.

The military had its own comment, from Army Chief of Staff Gen. George Casey, in its press release on the report.

http://www.defense.gov/releases/release.aspx?releaseid=13756

“This comprehensive review exposes gaps in how we identify, engage and mitigate high-risk behavior among our soldiers,” Casey said. “After nearly a decade of war, we must keep pace with the expanding needs of our strained Army, and continuously identify and address the gaps that exist in our policies, programs and services.”

Now let’s see what the Army does about it.