Trial reportNeurocritical care2011
Cerebral hemodynamic and metabolic effects of equi-osmolar doses mannitol and 23.4% saline in patients with edema following large ischemic stroke.
Trial report in Neurocritical care, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients.Neurocritical care · 2020Guideline
- Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations.Intensive care medicine · 2018Guideline
- Parenteral fluid regimens for improving functional outcome in people with acute stroke.The Cochrane database of systematic reviews · 2015Pooled it
- EPIDEMIOLOGY, DIAGNOSIS, MANAGEMENT AND PREVENTION OF STROKE: A NARRATIVE REVIEW.Annals of Ibadan postgraduate medicine · 2025Article
- Article
- Brain Swelling versus Infarct Size: A Problematizing Review.Brain sciences · 2024Review
- Admission Dehydration Status Portends Adverse Short-Term Mortality in Patients with Spontaneous Intracerebral Hemorrhage.Journal of clinical medicine · 2021Article
- Admission Dehydration Is Associated With Significantly Lower In-Hospital Mortality After Intracerebral Hemorrhage.Frontiers in neurology · 2021Article
- Management of Acute Ischemic Stroke.Critical care medicine · 2020Review
- Predicting cerebral edema in ischemic stroke patients.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2019Article
- 23.4% Saline Decreases Brain Tissue Volume in Severe Hepatic Encephalopathy as Assessed by a Quantitative CT Marker.Critical care medicine · 2016Article
- Treatment of malignant brain edema and increased intracranial pressure after stroke.Current treatment options in neurology · 2015Article
- Malignant cerebral edema after large anterior circulation infarction: a review.Current treatment options in cardiovascular medicine · 2014Article
- Real time estimation of brain water content in comatose patients.Annals of neurology · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
introductionCerebral edema after ischemic stroke is frequently treated with mannitol and hypertonic saline (HS); however, their relative cerebrovascular and metabolic effects are incompletely understood, and may operate independent of their ability to lower intracranial pressure.
methodsWe compared the effects of 20% mannitol and 23.4% saline on cerebral blood flow (CBF), blood volume (CBV), oxygen extraction fraction (OEF), and oxygen metabolism (CMRO(2)), in nine ischemic stroke patients who deteriorated and had >2 mm midline shift on imaging. (15)O-PET was performed before and 1 h after administration of randomly assigned equi-osmolar doses of mannitol (1.0 g/kg) or 23.4% saline (0.686 mL/kg).
resultsBaseline CBF values (ml/100g/min) in the infarct core, periinfarct region, remaining ipsilateral hemisphere, and contralateral hemisphere in the mannitol group were 5.0 ± 3.9, 25.6 ± 4.4, 35.6 ± 8.6, and 45.5 ± 2.2, respectively, and in the HS group were 8.3 ± 9.8, 35.3 ± 10.9, 38.2 ± 15.1, and 35.2 ± 12.4, respectively. There was a trend for CBF to rise in the contralateral hemisphere after mannitol from 45.5 ± 12.2 to 57.6 ± 21.7, P = 0.098, but not HS. CBV, OEF, and CMRO(2) did not change after administration of either agent. Change in CBF in the contralateral hemisphere after osmotic therapy was strongly correlated with baseline blood pressure (R (2)= 0.879, P = 0.002).
conclusionsWe conclude that at higher perfusion pressures, osmotic agents may raise CBF in non-ischemic tissue. We conclude that at higher perfusion pressures, osmotic agents may raise CBF in non-ischemic tissue.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.