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Osmotic Therapy in Traumatic Brain Injury

  • Traumatic Brain Injury (A Valadka, Section Editor)
  • Published:
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Abstract

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 increasing 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.

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Authors and Affiliations

  1. Department of Neurosurgery, Baylor College of Medicine, 7200 Cambridge, Suite 9A, MS: BCM650, Houston, TX, 77030, USA

    Aditya Vedantam & Shankar P. Gopinath

Authors
  1. Aditya Vedantam
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  2. Shankar P. Gopinath
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Correspondence to Shankar P. Gopinath.

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The authors declare no conflicts of interest relevant to this manuscript.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Traumatic Brain Injury

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Vedantam, A., Gopinath, S.P. Osmotic Therapy in Traumatic Brain Injury. Curr Trauma Rep 4, 121–126 (2018). https://doi.org/10.1007/s40719-018-0123-5

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  • DOI: https://doi.org/10.1007/s40719-018-0123-5

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