ReviewCurrent opinion in critical care2013
New trends in hyperosmolar therapy?
Review in Current opinion in critical care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.
- Cardiac output changes after osmotic therapy in neurosurgical and neurocritical care patients: a systematic review of the clinical literature.British journal of clinical pharmacology · 2018Pooled it
- Continuous 3% Saline Infusion Combined with 7.5% Hypertonic Saline Bolus is Associated with Lower Mortality in Patients with Severe Brain Injury: A Single-Center Retrospective Cohort Study.Neurocritical care · 2026Article
- Serum osmolality and hyperosmolar states.Pediatric nephrology (Berlin, Germany) · 2023Review
- Optimal Dose and Concentration of Hypertonic Saline in Traumatic Brain Injury: A Systematic Review.Medeniyet medical journal · 2022Article
- Evaluation of cerebral hemodynamics by transcranial Doppler ultrasonography and its correlation with intracranial pressure in an animal model of intracranial hypertension.Arquivos de neuro-psiquiatria · 2022Article
- A Quasi-Physiological Microfluidic Blood-Brain Barrier Model for Brain Permeability Studies.Pharmaceutics · 2021Article
- Designing electrode configuration of electroosmosis based edema treatment as a complement to hyperosmotic therapy.Acta neurochirurgica · 2021Article
- The Utility of a Point-of-Care Transcranial Doppler Ultrasound Management Algorithm on Outcomes in Pediatric Asphyxial Out-of-Hospital Cardiac Arrest - An Exploratory Investigation.Frontiers in medicine · 2021Article
- What is the Role of Hyperosmolar Therapy in Hemispheric Stroke Patients?Neurocritical care · 2020Review
- Interferon-Gamma Stimulated Murine MacrophagesBioelectricity · 2020Article
- Cerebral Edema in Traumatic Brain Injury: a Historical Framework for Current Therapy.Current treatment options in neurology · 2020Article
- Management of Elevated Intracranial Pressure: a Review.Current neurology and neuroscience reports · 2019Review
- The Medical Management of Cerebral Edema: Past, Present, and Future Therapies.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2019Review
- NFAT5 mediates hypertonic stress-induced atherosclerosis via activating NLRP3 inflammasome in endothelium.Cell communication and signaling : CCS · 2019Article
- Human iPSC-derived blood-brain barrier microvessels: validation of barrier function and endothelial cell behavior.Biomaterials · 2019Article
- A Precision Medicine Approach to Cerebral Edema and Intracranial Hypertension after Severe Traumatic Brain Injury: Quo Vadis?Current neurology and neuroscience reports · 2018Review
- Fluid Management in Acute Brain Injury.Current neurology and neuroscience reports · 2018Review
- Accidental strangulation in children by the automatic closing of a car window.Revista Brasileira de terapia intensiva · 2018Article
- Hypertonic saline administration and complex traumatic brain injury outcomes: a retrospective study.International journal of burns and trauma · 2018Article
- Microdialysate concentration changes do not provide sufficient information to evaluate metabolic effects of lactate supplementation in brain-injured patients.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
Abstract
purpose of reviewTo discuss trends in the use of osmotic therapy. RECENT
findingsUse of osmotic therapy has evolved from bolus administration of mannitol to routine use of hypertonic saline as a bolus as well as in continuous infusions to creating a sustained hyperosmolar state.In a survey of neurointensivists 55% favored hypertonic saline over mannitol. Retrospective studies suggest better intracranial pressure (ICP) control with hypertonic saline. Whereas a prospective study in adults with head injury compared alternating doses of mannitol and hypertonic saline and found no difference in change in ICP control or outcome, two meta-analyses, which did not include this study, favored hypertonic saline for ICP control (although the absolute difference of 2 mmHg is of little clinical value) with no difference in outcome.Hypertonic saline has also been administered by infusions to creating a sustained stable hyperosmolar state. Two studies, using historical controls, suggested benefit of hypertonic saline infusions. In a prospective, randomized study, in children with severe head injury Lactated Ringer's solution was compared to hypertonic saline. Although ICP control was similar, the hypertonic saline group required fewer other interventions. SUMMARY: The existing data do not support favoring boluses of hypertonic saline over mannitol in terms of ICP control, let alone outcome. The rationale for continuous infusions to create a sustained hyperosmolar state is open to discussion and use of this approach should be curtailed pending further research.
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Registered trials
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.