Table 1 Baseline characteristics of included studies
Author | Year | Country | Design | Intervention fluid | Control fluid | Patients | Outcomes |
|---|---|---|---|---|---|---|---|
Huang et al. [17] | 2020 | China | RCT | 10% HS | 20% M | Severe TBI with ICH | Repeated doses of 10% HTS and 20% M seems equally effective in treating ICH. HTS might have a slightly better role in changing ICP and CCP compared to M |
Patil and Gupta [18] | 2019 | India | RCT | 3% HS | 20% M Plus 10% M and 10% Glycerol | Severe TBI, GCS ≤ 8, ICP > 20 mmHg, > 5 min | Maximum changes in ICP, CCP and GCS occurred with 3% HTS followed by 10% M Plus 10% glycerol combo then 20% M. Better neurological outcome ē HTS and M + Glyc. Combo |
Kumar et al. [19] | 2019 | India | RCT | 3%HS | 20% M | Children with severe TBI and raised ICP | Both mannitol and hypertonic saline were equally effective for treatment of raised ICP |
Tsaousi et al. [20] | 2023 | Greece | RCT | 7.5% HS | 20% M | undergoing elective supratentorial craniotomy | HTS and M showed no significant differences. However, HTS had improvements in cerebral oxygenation and reduced neuronal damage compared to mannitol |
Du et al. [30] | 2017 | China | RCT | 3% HS | 20% M | Severe TBI ICP > 20 mmHg | HS was better than M in reducing ICP. Clinical outcome was not significantly improved |
Cottenceau et al. [21] | 2011 | France | RCT | 7.5% HS | 20% M | Severe TBI ICP > 15 mmHg | HS and M both reduced ICP and increased CPP |
Hendoui et al. [22] | 2013 | Iran | RCT | 5% HS | 20% M | Moderate to severe TBI. Scheduled therapy | S100B useful for treatment monitoring HS safe and effective in TBI |
Jagannatha et al. [23] | 2016 | India | RCT | 3% HS | 20% M | Severe TBI ICP > 20 mmHg > 10 min | HS: shorter duration of increased ICP and inotrope requirement |
Qin et al. [31] | 2018 | China | RCT | 3% HS | 20% M | Severe TBI, after decompressive Craniectomy ICP > 20 mmHg > 5 min | HS can decrease postoperative complications, and improve the prognosis of patients |
Vialet et al. [24] | 2003 | France | RCT | 7.5% HS | 20% M | Severe TBI ICP > 25 mmHg > 5 min | Less ICP episodes and treatment failure in HS group |
Francony et al. [25] | 2008 | France | RCT | 7.5%HS | 20% M | TBI and stroke ICP > 20 mmHg > 10 min | HS and M both reduced ICP effectively |
Huang et al. [26] | 2014 | China | RCT | 7.5% HS | 20% M | Severe TBI ICP > 20 mmHg > 5 min | HS and M similar on maximum ICP reduction, action onset, and duration of action |
Mao et al. [32] | 2007 | China | RCT | 3% HS | 20% M | Severe TBI, after decompressive Craniectomy ICP > 20 mmHg > 5 min | HS and M rapidly decrease ICP; HS has a longer duration of action |
Sakellardis et al. [27] | 2011 | Greece | RCT | 15% HS | 20% M | Severe TBI ICP > 20 mmHg > 5 min | HS and M equal on ICP reduction and duration of action |
Yan et al. [33] | 2013 | China | RCT | 3% HS | 20% M | Severe TBI after decompressive Craniectomy ICP > 25 mmHg > 5 min | HS can rapidly decrease ICP and increase MAP without obvious side effects |