Purpose of Review The goal of this paper is to review hyperosmolar therapy in patients with intracranial hypertension after traumatic brain injury (TBI). Recent Findings Recent studies that have compared hypertonic saline and mannitol for intracranial hypertension after TBI show greater intracranial pressure (ICP) control with hypertonic saline. However, these studies are limited by substantial variation in methodology, and the results fail to show improved neurological outcomes. Summary Although mannitol is the traditional hyperosmolar agent recommended for intracranial hypertension, there is increas- ing evidence for the safety and efficacy of hypertonic saline. Data from prior studies suggest that short-term differences in ICP control between hypertonic saline and mannitol appear to be insufficient to independently affect mortality or neurological outcome after severe TBI. A sufficiently powered, multicenter, randomized controlled trial focusing on hypertonic saline and mannitol in severe TBI patients is necessary to determine whether a particular hyperosmolar agent independently contributes to a superior neurological outcome. . . . . . Keywords Hyperosmolar therapy Hypertonic saline Intracranial hypertension Intracranial pressure Mannitol Severe traumatic brain injury Introduction hyperosmolar agent . The two major osmotic agents used in TBI are mannitol and hypertonic saline. In the present chap- The management of intracranial
Current Trauma Reports – Springer Journals
Published: Mar 7, 2018
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