Comparison of half-molar sodium lactate and mannitol to treat brain edema in severe traumatic brain injury: A systematic review.
10.1016/j.cjtee.2021.07.005
- Author:
Abdul Hafid BAJAMAL
1
;
Tedy APRIAWAN
1
;
I G M Aswin R RANUH
1
;
Franco SERVADEI
2
;
Muhammad FARIS
1
;
Asra AL FAUZI
3
Author Information
1. Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
2. Department of Neurosurgery, Humanitas Clinical and Research Hospital, Humanitas University, Milan, Italy.
3. Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Electronic address: asra.al@fk.unair.ac.id.
- Publication Type:Systematic Review
- Keywords:
Half-molar sodium lactate;
Mannitol;
Traumatic brain injuries
- MeSH:
Brain Edema;
Brain Injuries, Traumatic/drug therapy*;
Diuretics, Osmotic/therapeutic use*;
Humans;
Intracranial Hypertension/etiology*;
Intracranial Pressure;
Mannitol/therapeutic use*;
Prospective Studies;
Retrospective Studies;
Saline Solution, Hypertonic;
Sodium Lactate
- From:
Chinese Journal of Traumatology
2021;24(6):344-349
- CountryChina
- Language:English
-
Abstract:
PURPOSE:Hypertonic fluids such as mannitol and half-molar sodium lactate are given to treat intracranial hypertension in patients with severe traumatic brain injury (TBI). In this study, sodium lactate was compared to mannitol in patients with TBI to investigate the efficacy in reducing intracranial pressure (ICP).
METHODS:This study was a systematic review with literature research on articles published in any year in the databases of PubMed, ScienceDirect, Asian Journal of Neurosurgery, and Cochrane Central Register of Controlled Trials. The keywords were "half-molar sodium lactate", "mannitol", "cerebral edema or brain swelling", and "severe traumatic brain injury". The inclusion criteria were (1) studies published in English, (2) randomized control trials or retrospective/prospective studies on TBI patients, and (3) therapies including half-molar sodium lactate and mannitol and (4) sufficient data such as mean difference (MD) and risk ratio (RR). Data analysis was conducted using Review Manager 5.3.
RESULTS:From 1499 studies, a total of 8 studies were eligible. Mannitol group reduced ICP of 0.65 times (MD 0.65; p = 0.64) and improved cerebral perfusion pressure of 0.61 times (MD 0.61; p = 0.88), better than the half-molar group of sodium lactate. But the half-molar group of sodium lactate maintained the mean arterial pressure level of 0.86 times, better than the mannitol group (MD 0.86; p = 0.09).
CONCLUSION:Half-molar sodium lactate is as effective as mannitol in reducing ICP in the early phase of brain injury, superior over mannitol in an extended period. It is able to prevent intracranial hypertension and give better brain tissue perfusion as well as more stable hemodynamics. Blood osmolarity is a concern as it increases serum sodium.
