Sodium Lactate in Severe TBI

Inclusion Criteria: * GCS at enrollment 3-8 * Male or female aged 18-80 at admission * acute positive CT findings * ability for subject to comply with the requirements of the study * written informed consent obtained from subject or subject's legal representative. Exclusion Criteria: * Penetrating TBI * Polytrauma leading to instability of systemic: hemodynamics, acidosis, or severe acute lung injury during the inclusion period * History of neurological disease, including Parkinson's, Huntington's, Alzheimer's, etc. * History of diabetes mellitus * Serum sodium ≥ 148 mM * Metabolic acidosis pH \<7.34 * Coagulopathy INR \> 1.3, platelets \< 100,000, or hematocrit \< 28 mg/dl * Renal insufficiency with GFR \< 60% of expected or Cr \> 1.3; * AST or ALT \> 1.5x upper limit of normal; Severe liver trauma; * baseline serum lactate \> 2 mM * Hypotension SBP \< 90 refractory to vasopressors * Known mitochondrial genetic disorder * Pregnancy * Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data * Member of a protected population; simultaneous participation in another randomized trial