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Comparison of half-molar sodium lactate and mannitol to treat brain edema in severe traumatic brain injury: A systematic review / 中华创伤杂志(英文版)
Chinese Journal of Traumatology ; (6): 344-349, 2021.
Article in English | WPRIM | ID: wpr-922348
ABSTRACT
PURPOSE@#Hypertonic fluids such as mannitol and half-molar sodium lactate are given to treat intracranial hypertension in patients with severe traumatic brain injury (TBI). In this study, sodium lactate was compared to mannitol in patients with TBI to investigate the efficacy in reducing intracranial pressure (ICP).@*METHODS@#This study was a systematic review with literature research on articles published in any year in the databases of PubMed, ScienceDirect, Asian Journal of Neurosurgery, and Cochrane Central Register of Controlled Trials. The keywords were "half-molar sodium lactate", "mannitol", "cerebral edema or brain swelling", and "severe traumatic brain injury". The inclusion criteria were (1) studies published in English, (2) randomized control trials or retrospective/prospective studies on TBI patients, and (3) therapies including half-molar sodium lactate and mannitol and (4) sufficient data such as mean difference (MD) and risk ratio (RR). Data analysis was conducted using Review Manager 5.3.@*RESULTS@#From 1499 studies, a total of 8 studies were eligible. Mannitol group reduced ICP of 0.65 times (MD 0.65; p = 0.64) and improved cerebral perfusion pressure of 0.61 times (MD 0.61; p = 0.88), better than the half-molar group of sodium lactate. But the half-molar group of sodium lactate maintained the mean arterial pressure level of 0.86 times, better than the mannitol group (MD 0.86; p = 0.09).@*CONCLUSION@#Half-molar sodium lactate is as effective as mannitol in reducing ICP in the early phase of brain injury, superior over mannitol in an extended period. It is able to prevent intracranial hypertension and give better brain tissue perfusion as well as more stable hemodynamics. Blood osmolarity is a concern as it increases serum sodium.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Saline Solution, Hypertonic / Brain Edema / Intracranial Pressure / Prospective Studies / Retrospective Studies / Sodium Lactate / Intracranial Hypertension / Diuretics, Osmotic / Brain Injuries, Traumatic / Mannitol Type of study: Observational study / Systematic reviews Limits: Humans Language: English Journal: Chinese Journal of Traumatology Year: 2021 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Saline Solution, Hypertonic / Brain Edema / Intracranial Pressure / Prospective Studies / Retrospective Studies / Sodium Lactate / Intracranial Hypertension / Diuretics, Osmotic / Brain Injuries, Traumatic / Mannitol Type of study: Observational study / Systematic reviews Limits: Humans Language: English Journal: Chinese Journal of Traumatology Year: 2021 Type: Article