SynthesisCritical care (London, England)2017
Association between continuous hyperosmolar therapy and survival in patients with traumatic brain injury - a multicentre prospective cohort study and systematic review.
Synthesis in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses 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
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Mechanical ventilation in patients with acute brain injury: a systematic review with meta-analysis.Critical care (London, England) · 2023Pooled it
- 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
- Trial
- 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
- The Physiology, Pathophysiology, and Clinical Implications of Fluid Resuscitation in Critically Ill Patients.Cureus · 2026Review
- Global, regional, and national burdens of traumatic brain injury from 1990 to 2021.Frontiers in public health · 2025Article
- Managing Intracranial Pressure Crisis.Current neurology and neuroscience reports · 2024Review
- Time to death and its predictors among traumatic brain injury patients admitted to East Amhara comprehensive specialized hospitals, Ethiopia: retrospective cohort study.BMC neurology · 2024Article
- Mapping the costs and socioeconomic characteristics involved in traumatic brain injuries: a scoping review.Journal of rehabilitation medicine · 2024Article
- Effect of continuous hypertonic saline infusion on clinical outcomes in patients with traumatic brain injury.Neurosurgical review · 2024Article
- Osmotic Demyelination Syndrome in the Setting of Normonatremia: A Case Report and Review of the Literature.Case reports in neurological medicine · 2024Article
- Evidence-based management of adult traumatic brain injury with raised intracranial pressure in intensive critical care unit at resource-limited settings: a literature review.Annals of medicine and surgery (2012) · 2023Review
- [Focus neurosurgical intensive care medicine : Summary of selected intensive medical care studies].Die Anaesthesiologie · 2023Article
- Variability in Serum Sodium Concentration and Prognostic Significance in Severe Traumatic Brain Injury: A Multicenter Observational Study.Neurocritical care · 2021Observational
- Traumatic Brain Injury-A Review of Intravenous Fluid Therapy.Frontiers in veterinary science · 2021Review
- Hyperosmolar Treatment for Patients at Risk for Increased Intracranial Pressure: A Single-Center Cohort Study.International journal of environmental research and public health · 2020Article
- Cerebral Edema in Traumatic Brain Injury: a Historical Framework for Current Therapy.Current treatment options in neurology · 2020Article
- Hyperosmolar therapy for acute brain injury: study protocol for an umbrella review of meta-analyses and an evidence mapping.BMJ open · 2020Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 12 institutions in 2 countries.
Funding
Abstract
backgroundIntracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared the mortality and outcomes in patients with TBI with ICH treated or not with CHT.
methodsWe included patients with TBI (Glasgow Coma Scale ≤ 12 and trauma-associated lesion on brain computed tomography (CT) scan) from the databases of the prospective multicentre trials Corti-TC, BI-VILI and ATLANREA. CHT consisted of an intravenous infusion of NaCl 20% for 24 hours or more. The primary outcome was the risk of survival at day 90, adjusted for predefined covariates and baseline differences, allowing us to reduce the bias resulting from confounding factors in observational studies. A systematic review was conducted including studies published from 1966 to December 2016.
resultsAmong the 1086 included patients, 545 (51.7%) developed ICH (143 treated and 402 not treated with CHT). In patients with ICH, the relative risk of survival at day 90 with CHT was 1.43 (95% CI, 0.99-2.06, p = 0.05). The adjusted hazard ratio for survival was 1.74 (95% CI, 1.36-2.23, p < 0.001) in propensity-score-adjusted analysis. At day 90, favourable outcomes (Glasgow Outcome Scale 4-5) occurred in 45.2% of treated patients with ICH and in 35.8% of patients with ICH not treated with CHT (p = 0.06). A review of the literature including 1304 patients from eight studies suggests that CHT is associated with a reduction of in-ICU mortality (intervention, 112/474 deaths (23.6%) vs. control, 244/781 deaths (31.2%); OR 1.42 (95% CI, 1.04-1.95), p = 0.03, I
conclusionsCHT for the treatment of posttraumatic ICH was associated with improved adjusted 90-day survival. This result was strengthened by a review of the literature.
Indexed as
Identifiers
What OpenQuestion holds
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.