Evidence map›Paper›PMID 31486921›Full record

ArticleAnnals of intensive care2019

Serum sodium and intracranial pressure changes after desmopressin therapy in severe traumatic brain injury patients: a multi-centre cohort study.

A Harrois, J R Anstey, F S Taccone, A A Udy, G Citerio, J Duranteau, C Ichai, R Badenes, J R Prowle, A Ercole and 10 more

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of intensive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 10 institutions in 12 countries.

A HarroisIntensive Care Unit, Royal Melbourne Hospital, Parkville, VIC, Australia. harroisanatole@yahoo.fr.ORCID http://orcid.org/0000-0002-5098-4656
J R AnsteyIntensive Care Unit, Royal Melbourne Hospital, Parkville, VIC, Australia.
F S TacconeDepartment of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
A A UdyIntensive Care Unit, The Alfred Hospital, Melbourne, VIC, Australia.
G CiterioSchool of Medicine and Surgery, University Milano Bicocca-Neurointensive Care, San Gerardo Hospital, ASST-Monza, Monza, Italy.
J DuranteauDepartment of Anesthesia and Surgical Intensive Care, CHU de Bicetre, APHP, Université Paris Sud, 78 Rue du Général Leclerc, 94270, Le Kremlin Bicêtre, France.
C IchaiUniversité Côte d'Azur, Centre hospitalier Universitaire de Nice, Service de Réanimation Polyvalente, Hôpital Pasteur 2, Nice, France.
R BadenesDepartment of Anesthesiology and Surgical-Trauma Intensive Care, Hospital Clinic Universitari de Valencia, University of Valencia, Valencia, Spain.
J R ProwleAdult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, London, UK.
A ErcoleNeurosciences and Trauma Critical Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
M OddoDepartment of Medical-Surgical Intensive Care Medicine, Faculty of Biology and Medicine, Centre Hospitalier Universitaire, Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland.
A SchneiderDepartment of Medical-Surgical Intensive Care Medicine, Faculty of Biology and Medicine, Centre Hospitalier Universitaire, Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland.
M van der JagtDepartment of Intensive Care, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.
S WolfDepartment of Neurosurgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
R HelbokNeurological Intensive Care Unit, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
D W NelsonSection for Perioperative Medicine and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
M B SkrifvarsDivision of Intensive Care, Department of Emergency Care and Services, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
D J CooperDepartment of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
R BellomoIntensive Care Unit, Royal Melbourne Hospital, Parkville, VIC, Australia.
TBI Collaborative
Université Paris-Sud · FRThe Royal Melbourne Hospital · AUErasmus MC · NLInnsbruck Medical University · ATUniversitat de València · ESUniversité Libre de Bruxelles · BEUniversity Hospital of Lausanne · CHBarts Health NHS Trust · GBThe Alfred Hospital · AUUniversity of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn traumatic brain injury (TBI) patients desmopressin administration may induce rapid decreases in serum sodium and increase intracranial pressure (ICP).

aimIn an international multi-centre study, we aimed to report changes in serum sodium and ICP after desmopressin administration in TBI patients.

methodsWe obtained data from 14 neurotrauma ICUs in Europe, Australia and UK for severe TBI patients (GCS ≤ 8) requiring ICP monitoring. We identified patients who received any desmopressin and recorded daily dose, 6-hourly serum sodium, and 6-hourly ICP.

resultsWe studied 262 severe TBI patients. Of these, 39 patients (14.9%) received desmopressin. Median length of treatment with desmopressin was 1 [1-3] day and daily intravenous dose varied between centres from 0.125 to 10 mcg. The median hourly rate of decrease in serum sodium was low (- 0.1 [- 0.2 to 0.0] mmol/L/h) with a median period of decrease of 36 h. The proportion of 6-h periods in which the rate of natremia correction exceeded 0.5 mmol/L/h or 1 mmol/L/h was low, at 8% and 3%, respectively, and ICPs remained stable. After adjusting for IMPACT score and injury severity score, desmopressin administration was independently associated with increased 60-day mortality [HR of 1.83 (1.05-3.24) (p = 0.03)].

conclusionsIn severe TBI, desmopressin administration, potentially representing instances of diabetes insipidus is common and is independently associated with increased mortality. Desmopressin doses vary markedly among ICUs; however, the associated decrease in natremia rarely exceeds recommended rates and median ICP values remain unchanged. These findings support the notion that desmopressin therapy is safe.

Indexed as

DesmopressinDiabetes insipidusNatremiaSodiumTraumatic brain injury

Identifiers

PMID31486921
PMCPMC6728106
OpenAlexW2971429452

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.