Bergmans SF, Schober P, Schwarte LA, et al. - In patients with severe traumatic brain injury (TBI), fluid resuscitation is traditionally used in prehospital hypotension treatment, so researchers evaluated the impact of various fluid types on outcome since the optimal fluid to be used is still uncertain. Up to March 2020, PubMed, Embase, and Web of Science were searched for studies assessing two or more prehospital administered fluid types to patients with suspected or confirmed severe TBI were considered to be eligible for this systematic review and meta-analysis. Differences in survival between hypertonic saline (HTS) and normotonic crystalloids (i.e. normal saline or Lactated Ringer's) and between hypertonic saline with dextran (HSD) and normotonic crystalloids were assessed in these studies. Out of 519 articles, they used 12 in the systematic review and 6 in the meta-analysis. No statistically significant survival difference was found between patients treated with different types of fluid (eg, normal saline and hypertonic saline) in 11 of the studies. In the prehospital setting, no survival or neurological benefit for one specific fluid type over another was seen when treating patients with TBI.