https://doi.org/10.4081/ecj.2024.12310

Comparative efficacy analysis of mannitol and hypertonic saline in the management of traumatic brain injury: a scientific exploration of neuroprotective strategies

Vol. 20 No. 2 (2024)
Submitted: 25 January 2024
Accepted: 29 April 2024
Published: 27 May 2024
Traumatic brain injury, mannitol, hypertonic saline, cerebral edema, intracranial pressure, brain trauma, osmotherapy, fluid management
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Supplementary Materials: 7
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Authors

Kishore Nagaraju
nkishore2468@gmail.com
https://orcid.org/0009-0000-2206-7597
Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, PES University, Bangalore, India.
Leema Lobo
Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, PES University, Bangalore, India.
Manjari Sharma
Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, PES University, Bangalore, India.

In the management of severe traumatic brain injuries (TBIs), controlling intracranial pressure (ICP) is a pivotal therapeutic goal. Historically, mannitol has been the recommended first-line osmotic agent; however, concerns surrounding its use, including hypotension, rebound ICP elevation, and renal toxicity, have prompted a quest for alternative strategies. Hypertonic saline (HS) has emerged as a promising substitute, demonstrating efficacy in reducing ICP without compromising cerebral perfusion. This comprehensive analysis explores the comparative effectiveness of Mannitol and Hypertonic Saline in the context of severe TBIs. While Mannitol has been a longstanding choice, recent attention has shifted towards HS due to its reported superiority in ICP reduction. Concerns associated with mannitol, such as hypotension and rebound ICP, are juxtaposed against the potential advantages offered by HS. The scarcity of clinical studies focusing on TBI-related outcomes, such as patient survival and long-term benefits, is highlighted, underscoring a critical gap in the current knowledge landscape. The review aims to provide a nuanced understanding of the comparative effectiveness of Mannitol and Hypertonic Saline, considering not only ICP control but also broader patient outcomes. By addressing the suitability of these agents in diverse clinical settings, this analysis seeks to guide clinicians in making informed decisions tailored to individual patient needs.

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How to Cite

Nagaraju, K., Lobo, L., & Sharma, M. (2024). Comparative efficacy analysis of mannitol and hypertonic saline in the management of traumatic brain injury: a scientific exploration of neuroprotective strategies. Emergency Care Journal, 20(2). https://doi.org/10.4081/ecj.2024.12310
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