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Saline vs. Mannitol for Elevated Intracranial Tension

Discussion in 'Emergency Medicine' started by Egyptian Doctor, Mar 22, 2011.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Mannitol is standard treatment for suspected elevated intracranial pressure (ICP), but it has been implicated in undesirable reductions in mean arterial blood pressure. Researchers performed a meta-analysis of five unblinded randomized trials that compared equiosmolar doses of mannitol and hypertonic saline in a combined total of 112 adult patients with 184 quantitatively documented episodes of elevated ICP. None of the five trials individually identified statistically significant differences between the two agents.

    Combining data from the five trials resulted in slight superiority of hypertonic saline over mannitol (relative risk for ICP reduction, 1.16). The difference in magnitude of ICP reduction with the two agents was not clinically significant.

    Comment: This small meta-analysis of unblinded studies of patients with mixed etiologies of elevated intracranial pressure does not provide sufficient evidence to change therapy from mannitol to hypertonic saline.
     

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  2. Hendra Gandhi

    Hendra Gandhi Moderator

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    so mannitol still the one good for ICP reduction..
     


  3. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    Yes i think so
     


  4. g12321

    g12321 Super Moderator

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    I think so, well that's what I wrote for my paper today for that question.
     


  5. Clothes

    Clothes Well-Known Member

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    Big thanks

    Big thanks
     


  6. Dr.jebsy

    Dr.jebsy Well-Known Member

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    thanks
     


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