Jiajie Gu, 2018 |
RCT |
n=12 |
n=438 |
(1) The pooled MD of maximal ICP
reduction, comparing HTS to mannitol was −0.16 (95% CI: −0.59 to 0.27,
p = 0.473). (2) The pooled relative risk of successful ICP control was
1.06 (95% CI: 1.00 to 1.13, p = 0.044). |
There is no specific
recommendation to select HTS or mannitol as a first-line agent for TBI. |
Low |
Elyse Berger-Pelleiter, 2016 |
RCT |
n=11 |
n=1820 |
HTS did not improve
ICP control (WMD −1.25 mm Hg, 95% CI −4.18 to 1.68,
I2 = 78%) as compared to any other solutions. |
There
is no difference between HTS and other solutions in ICP reduction. |
Moderate |
Sarah Burgess, 2016 |
RCT |
n=7 |
n=191 |
Risk of ICP treatment failure
favored HTS (risk ratio = 0.39; 95% CI = 0.18-0.81). |
There is no
significant difference between HTS and mannitol for mean ICP reduction.
HTS appears to lead to fewer ICP treatment failures. |
Low |
Min Li, 2015 |
RCT; 2-arm prospective studies |
n=7 |
n=169 |
A pooled
MD = -1.69 (95% CI: 2.95 to 0.44, P = 0.008) indicated that HTS reduced
ICP more effectively than mannitol when compared from the baseline value
to the last measurement after treatment. |
HTS is more effective than
mannitol for reducing ICP in TBI. |
Low |
A C Rickard, 2013 |
RCT |
n=6 |
n=171 (599 episodes of raised ICP) |
The
WMD in ICP reduction, using HTS solutions compared with mannitol, was
1.39 mm Hg (95% CI −0.74 to 3.53). |
There is no significant difference
between HTS and mannitol for ICP reduction. |
Critical
Low |
Martin M. Mortazavi, 2012 |
RCT; nonrandomized
prospective observational trials; retrospective
trials
|
n=36 |
n=823 |
A higher rate of treatment failure or insufficiency with
mannitol versus HTS (OR=0.36, 95% CI: 0.19 to 0.68). |
HTS given as
either a bolus or continuous infusion can be more effective than
mannitol in reducing episodes of elevated ICP. |
Critical
Low |
Hooman Kamel, 2011 |
RCT |
n=5 |
n=112 |
The relative risk of ICP
control was 1.16 (95% CI, 1.00–1.33), and the difference in mean ICP
reduction was 2.0 mmHg (95% CI: 1.6 to 5.7), with both favoring HTS
over mannitol. |
HTS is more effective than mannitol for treatment of
elevated ICP. |
Critical Low |