Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2011
Brain swelling and mannitol therapy in adult cerebral malaria: a randomized trial.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 1 of them a synthesis 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
54 citing papers in PubMed, 1 synthesis or guideline pooled it, 101 citations in OpenAlex.
- Outcomes reported in trials of treatments for severe malaria: The need for a core outcome set.Tropical medicine & international health : TM & IH · 2022Pooled it
- CD8+ T cells target cerebrovasculature in children with cerebral malaria.The Journal of clinical investigation · 2020Trial
- Randomized controlled trial of levamisole hydrochloride as adjunctive therapy in severe falciparum malaria with high parasitemia.The Journal of infectious diseases · 2014Trial
- Management and monitoring strategies for severe cerebral malaria: a guide for the intensivist.Annals of intensive care · 2025Review
- Cerebral manifestations of falciparum malaria in adults: more than meets the eye.Trends in parasitology · 2025Review
- Contribution of Magnetic Resonance Imaging Studies to the Understanding of Cerebral Malaria Pathogenesis.Pathogens (Basel, Switzerland) · 2024Review
- ISCCM Position Statement on the Management of Severe Malaria in Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- DON in pediatric cerebral malaria, a phase I/IIA dose-escalation safety study: study protocol for a clinical trial.Trials · 2024Article
- Sudden Onset of Coma and Fulminant Progression to Brain Death in a 48-Year-Old Male With Cerebral Malaria.Case reports in critical care · 2024Article
- Exploring adjunctive therapies for cerebral malaria.Frontiers in cellular and infection microbiology · 2024Review
- Plasmodium Vivax as a Causative Agent for Cerebral Malaria in a Group of Adults at Mizan Tepi Teaching Hospital: Case Series.International medical case reports journal · 2024Article
- Review
- Pathogenesis of Cerebral Malaria: New Trends and Insights for Developing Adjunctive Therapies.Pathogens (Basel, Switzerland) · 2023Article
- Epidemiological shifts: the emergence of malaria in America.Proceedings (Baylor University. Medical Center) · 2023Review
- Recent Advances in Imported Malaria Pathogenesis, Diagnosis, and Management.Current emergency and hospital medicine reports · 2023Review
- Diagnosis of cerebral malaria: Tools to reduceFrontiers in cellular and infection microbiology · 2023Review
- Advances in Basic and Translational Research as Part of the Center for the Study of Complex Malaria in India.The American journal of tropical medicine and hygiene · 2022Article
- Severe malaria.Malaria journal · 2022Review
- Evidence of Brain Alterations in Noncerebral Falciparum Malaria.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Genetics of cerebral malaria: pathogenesis, biomarkers and emerging therapeutic interventions.Cell & bioscience · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundComa is a frequent presentation of severe malaria in adults and an important cause of death. The role of cerebral swelling in its pathogenesis, and the possible benefit of intravenous mannitol therapy to treat this, is uncertain.
methodsA computed tomographic (CT) scan of the cerebrum and lumbar puncture with measurement of cerebrospinal fluid (CSF) pressure were performed on admission for 126 consecutive adult Indian patients with cerebral malaria. Patients with brain swelling on CT scan were randomized to adjunctive treatment with intravenous mannitol (1.5 g/kg followed by 0.5 g/kg every 8 hours; n = 30) or no adjunctive therapy (n = 31).
resultsOn CT scan 80 (63%) of 126 patients had cerebral swelling, of whom 36 (29%) had moderate or severe swelling. Extent of brain swelling was not related to coma depth or mortality. CSF pressures were elevated (≥200 mm H(2)O) in 43 (36%) of 120 patients and correlated with CT scan findings (P for trend = .001). Mortality with mannitol therapy was 9 (30%) of 30 versus 4 (13%) of 31 without adjunctive therapy (hazard ratio, 2.4 [95% confidence interval, 0.8-7.3]; P = .11). Median coma recovery time was 90 hours (range, 22-380 hours) with mannitol versus 32 hours (range, 5-168 hours) without (P = .02).
conclusionsBrain swelling on CT scan is a common finding in adult patients with cerebral malaria but is not related to coma depth or survival. Mannitol therapy as adjunctive treatment for brain swelling in adult cerebral malaria prolongs coma duration and may be harmful.
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