Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • MCI News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Aborad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • MCI News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Aborad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Pediatrics and Neonatology
  • Pediatrics and Neonatology News
  • Hypertonic Saline...

Hypertonic Saline bests Mannitol in Reducing ICP due to CNS infections in kids: Study

MD BureauWritten by MD Bureau Published On 2021-02-01T19:45:02+05:30  |  Updated On 6 Oct 2023 12:13 PM GMT
Hypertonic Saline bests Mannitol in Reducing ICP due to CNS infections in kids: Study
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • koo
  • Email

Mannitol and hypertonic saline (HS) are hyperosmolar solutions commonly used to reduce intracranial pressure (ICP) and brain volume during neurosurgery or critical care unit admissions. In children with increased ICP due to Central nervous system (CNS) infection, treatment with hypertonic saline (3%) had better outcomes than 20% mannitol, suggests a randomized control trial published in...

Mannitol and hypertonic saline (HS) are hyperosmolar solutions commonly used to reduce intracranial pressure (ICP) and brain volume during neurosurgery or critical care unit admissions. In children with increased ICP due to Central nervous system (CNS) infection, treatment with hypertonic saline (3%) had better outcomes than 20% mannitol, suggests a randomized control trial published in the journal Pediatric Critical Care Medicine.

Hyperosmolar treatment is one of the important methods for treating Traumatic Brain Injury (TBI) and has been employed since early 1960. However, it may precipitate acute renal failure if serum osmolarity exceeds 320 mOsm/L and there are concerns of elevated serum concentrations of mannitol and rebound intracranial hypertension. Concerns with the use of mannitol have led to an interest in other agents. Hypertonic saline appears to be safe, and elevations of serum sodium with the use of hypertonic saline have not been associated with significant neurologic, cardiac, or renal injury. In traumatic brain injury (adult and pediatric), hypertonic saline (3%) shows varied results in comparison with 20% mannitol. Therefore researchers of Postgraduate Institute of Medical Education and Research (PGIMER), India, conducted a randomized control trial (RCT) to compare the effect of 3% hypertonic saline versus 20% mannitol on raised intracranial pressure in pediatric acute CNS infections.

It was an open-label, randomized controlled trial in 57 Children of 1–12 years old, with raised intracranial pressure and modified-Glasgow Coma Scale scores less than or equal to 8. They were randomly assigned to receive either 20%-mannitol (n = 28), 0.5 gram/kg/dose or 3%-hypertonic saline (n = 29), 10 mL/kg loading followed by 0.5–1 mL/kg/hr infusion. Researchers used an intraparenchymal catheter to monitor the intracranial pressure. The major outcome assessed was the proportion of patients achieved target average intracranial pressure less than 20 mm Hg during 72 hours. They also assessed interventions, morbidity, and mortality rate.

Key findings of the study were:

• Researchers observed that the proportion of patients with target average intracranial pressure (< 20 mm Hg) was higher in hypertonic saline-group (79.3%) as compared to mannitol-group (53.6%) with an adjusted hazard ratio of about 2.63.

• They found that mean reduction of intracranial pressure (–14.3 ± 1.7 vs –5.4 ± 1.7 mm Hg) and elevation of cerebral perfusion pressure (15.4 ± 2.4 vs 6 ± 2.4 mm Hg) from baseline were significant in hypertonic saline-group.

• They also found that mean intracranial pressure over 72 hours was lower (14 ± 2 vs 22 ± 2 mm Hg), and cerebral perfusion pressure was higher (65 ± 2.2 vs 58 ± 2.2) in hypertonic saline-group.

• Additionally, they noted a 3% increase in cerebral perfusion pressure (CPP) (15.4 vs 6 mm Hg), higher modified GCS at 72 hours (median 10 vs 7), lower mortality (20.7% vs 35.7%), shorter duration of mechanical ventilation (5 vs 15 days), shorter PICU stay (11 vs 19 days), and less neurodisability at discharge (31% vs 61%).

The authors concluded, "In pediatric acute CNS infections, 3%-hypertonic saline was associated with a greater reduction of intracranial pressure as compared to 20% mannitol".

For further information:

https://journals.lww.com/pccmjournal/Abstract/2020/12000/Randomized_Clinical_Trial_of_20__Mannitol_Versus.7.aspx


childrencomaintracranial hypertensionoutcomeosmotherapyPediatric Critical Care Medicine
Article Source :  Pediatric Critical Care Medicine
MD Bureau
MD Bureau

    Medical Dialogues Bureau consists of a team of passionate medical/scientific writers, led by doctors and healthcare researchers.  Our team efforts to bring you updated and timely news about the important happenings of the medical and healthcare sector. Our editorial team can be reached at editorial@medicaldialogues.in.

    Show Full Article

    More News

    Next Story
    Similar Posts
    NO DATA FOUND

    Editorial

    Journal Club Today

    Health News Today

    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X