Hypertonic Saline for Increased Intracranial Pressure

doi:10.1542/gr.45-4-40

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Source: Rameshkumar R, , Bansal A, , Singhi S, , et al. Randomized clinical trial of 20% mannitol versus 3% hypertonic saline in children with raised intracranial pressure due to acute CNS infections.* Pediatr Crit Care Med. 2020 Dec;21(12):1071–1080. doi: 10.1097/PCC.0000000000002557OpenUrl

Investigators from the Postgraduate Institute of Medical Education and Research, Chandigarh, India, conducted a randomized trial to compare outcomes in children with increased intracranial pressure (iICP) due to acute central nervous system (CNS) infection. Children were eligible if they were 1-12 years old and were admitted to the study pediatric intensive care unit (PICU) with an acute CNS infection (defined as presence of fever and CNS dysfunction for ≤7 days), clinical or radiological evidence of iICP, and a modified Glasgow Coma Scale (mGCS) score of ≤8. Demographic and clinical and radiographic data were collected at baseline.

Participants were randomized to receive 20% mannitol, administered as a 0.5 g/kg bolus (then as needed every 4 hours), or 3% …

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