Trial reportJournal of critical care2012
Effect of osmotic agents on regional cerebral blood flow in traumatic brain injury.
Trial report in Journal of critical care, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 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
8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Hypertonic Saline Compared to Mannitol for the Management of Elevated Intracranial Pressure in Traumatic Brain Injury: A Meta-Analysis.Frontiers in surgery · 2021Pooled it
- Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations.Intensive care medicine · 2018Guideline
- Escalate and De-Escalate Therapies for Intracranial Pressure Control in Traumatic Brain Injury.Frontiers in neurology · 2020Review
- Mannitol decreases neocortical epileptiform activity during early brain development via cotransport of chloride and water.Neurobiology of disease · 2019Article
- The Effects of Induction and Treatment of Intracranial Hypertension on Cerebral Autoregulation: An Experimental Study.Neurology research international · 2018Article
- A Review of the Effectiveness of Neuroimaging Modalities for the Detection of Traumatic Brain Injury.Journal of neurotrauma · 2015Review
- Traumatic Brain Injury pathophysiology and treatments: early, intermediate, and late phases post-injury.International journal of molecular sciences · 2013Review
- Beyond intracranial pressure: optimization of cerebral blood flow, oxygen, and substrate delivery after traumatic brain injury.Annals of intensive care · 2013Article
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 1 institution in 1 country.
Funding
Abstract
purposeCerebral blood flow (CBF) is reduced after severe traumatic brain injury (TBI) with considerable regional variation. Osmotic agents are used to reduce elevated intracranial pressure (ICP), improve cerebral perfusion pressure, and presumably improve CBF. Yet, osmotic agents have other physiologic effects that can influence CBF. We sought to determine the regional effect of osmotic agents on CBF when administered to treat intracranial hypertension. MATERIALS AND
methodsIn 8 patients with acute TBI, we measured regional CBF with positron emission tomography before and 1 hour after administration of equi-osmolar 20% mannitol (1 g/kg) or 23.4% hypertonic saline (0.686 mL/kg) in regions with focal injury and baseline hypoperfusion (CBF <25 mL per 100 g/min).
resultsThe ICP fell (22.4 ± 5.1 to 15.7 ± 7.2 mm Hg, P = .007), and cerebral perfusion pressure rose (75.7 ± 5.9 to 81.9 ± 10.3 mm Hg, P = .03). Global CBF tended to rise (30.9 ± 3.7 to 33.1 ± 4.2 mL per 100 g/min, P = .07). In regions with focal injury, baseline flow was 25.7 ± 9.1 mL per 100 g/min and was unchanged; in hypoperfused regions (15% of regions), flow rose from 18.6 ± 5.0 to 22.4 ± 6.4 mL per 100 g/min (P < .001). Osmotic therapy reduced the number of hypoperfused brain regions by 40% (P < .001).
conclusionOsmotic agents, in addition to lowering ICP, improve CBF to hypoperfused brain regions in patients with intracranial hypertension after TBI.
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Registered trials
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