3.1. Literature search and characteristics of included studies
As shown in Fig 1, our literature search covers 2257 articles. The
remaining 1814 studies were reviewed through skimming title and abstract
after eliminating duplicates. Then, 69 articles were screened out for
further full-text reading. After reading, we excluded 59 studies which
did not confirm to inclusion criteria. Finally, 10 studies were selected
for further meta-analysis.
Ten studies with a total of 384 patients (1578 episodes) were covered in
this systematic review and meta-analysis. In each study, the demographic
characteristics of the two groups were similar. And the characteristics
of qualified studies are summarized in Table 1. Six studies defined any
spontaneous ICP increase to >20 mmHg as an independent
elevated ICP episode, then started mannitol or HTS treatment and
recorded changes of ICP (2, 4, 5, 13-15). In these studies, total number
of episodes were considered as final sample size. And the number of
patient was considered as sample size in other four studies which did
not define elevated ICP episodes. Therefore, the sample size ranged from
20 to 488. There were three groups in study of Patil, H. and Ichai, C.,
and the interested data only from mannitol group and HTS group which
were extracted (13, 16). In all included trials, HTS solutions ranging
in concentrations from 3% to 15% were compared with 15% or 20%
mannitol.