SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025
Therapeutic comparison of hypertonic saline and mannitol in pediatric intracranial hypertension: a systematic review and meta-analysis.
Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- Serious methodological and numerical concerns regarding a meta-analysis of hypertonic saline versus mannitol in pediatric intracranial hypertension.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElevated intracranial pressure (ICP) in pediatric patients is a critical condition that can lead to severe complications if not managed promptly. Hypertonic saline and mannitol are both commonly used to reduce ICP, yet their comparative effectiveness remains uncertain. Despite widespread use, existing studies show mixed results, with variations in treatment protocols and patient outcomes. This uncertainty underscores the need for a clearer understanding of the most effective treatment for pediatric ICP management.
aimTo compare the effectiveness of hypertonic saline and mannitol in the management of elevated intracranial pressure in pediatric patients.
methodsA systematic review and meta-analysis, based on the preferred reporting items for systematic reviews and meta-analysis statements, was conducted (PROSPERO: CRD420251037689). A literature review was performed (sources: PubMed, Embase, and Cochrane Library databases; end-of-search date: April 15, 2025), and quality assessment was performed using the ROB2 and NewCastle Ottawa Scale. A random-effects model was used to pool the data for the meta-analyses.
resultsA total of 631 patients from five studies were included in the mortality analysis, with 367 in the HTS group and 264 in the mannitol group. The risk of mortality was not significantly different between groups (RR, 0.91; 95% CI, 0.54, 1.52; p = 0.71), with moderate heterogeneity observed (I
conclusionsThis meta-analysis found no significant differences in mortality, ICP, or CPP changes between the HTS and mannitol groups. Secondary outcomes, including ICU and hospital length of stay and mechanical ventilation duration, also showed no notable differences. These findings suggest that both hypertonic saline and mannitol may be similarly effective for managing elevated ICP in pediatric patients.
Indexed as
Identifiers
41420712What 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.