UMEM Educational Pearls

Category: Trauma

Title: Hypertonic Saline or Mannitol for Head Injury?

Keywords: Head injury mannitol saline ICP (PubMed Search)

Posted: 10/1/2023 by Robert Flint, MD (Updated: 7/14/2024)
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"The main findings were the following: (1) there was no evidence of an effect of HTS compared with other agents (mainly mannitol) on long-term neurological outcome in patients with raised ICP; (2) similarly, there was no evidence of a beneficial effect of HTS on all-cause mortality, uncontrolled ICP, length of hospital or ICU stay, and ICP reduction; and (3) HTS may be associated with increased risk of adverse hypernatremia.”



Bernhardt, K., McClune, W., Rowland, M.J. et al. Hypertonic Saline Versus Other Intracranial-Pressure-Lowering Agents for Patients with Acute Traumatic Brain Injury: A Systematic Review and Meta-analysis. Neurocrit Care (2023).