BACKGROUND: Intracranial @entity101 , defined as an @entity428 ( @entity428 ) >20 mmHg for a period of more than 5 min, worsens neurologic outcome in @entity131 ( @entity131 ). While several mechanisms contribute to poor outcome, impaired cerebral perfusion appears to be a highly significant common denominator. Management guidelines from the @entity131 Foundation recommend measuring @entity428 to guide therapy. In particular, hyperosmolar therapy, which includes @entity2656 or @entity4372 ( @entity4372 ), is frequently administered to reduce @entity428 . Currently, @entity2656 (20%) is considered the gold standard hyperosmolar agent. However, @entity4372 is increasingly used in this setting. This review sought to compare the efficacy of @entity2656 to @entity4372 in severe @entity131 . METHODS: The PubMed database was used to systematically search for articles comparing @entity2656 to @entity4372 in severe @entity131 . The following medical subject headings were used: @entity4372 , @entity19794 , @entity2656 , @entity428 , @entity428 , and @entity131 . We included both prospective and retrospective randomized controlled studies of adult @entity1 with @entity428 as a result of severe @entity131 who received hyperosmolar therapy. RESULTS: Out of 45 articles, seven articles were included in our review: 5 were prospective, randomized trials; one was a prospective, nonrandomized trial; and one was a retrospective, cohort study. CONCLUSIONS: While all seven studies found that both @entity2656 and @entity4372 were effective in reducing @entity428 , there was heterogeneity with regard to which agent was most efficacious.

XXXX or @entity4372 in the setting of @entity131 : What have we learned?

@entity2656 :: ('MESH:D008353', 'Chemical') :: ['mannitol'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity131 :: ('MESH:D001930', 'Disease') :: ['Brain Trauma', 'TBI', 'traumatic brain injury'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity428 :: ('MESH:D019586', 'Disease') :: ['ICP', 'intracranial hypertension', 'intracranial pressure'] @entity4372 :: ('MESH:D009122', 'Disease') :: ['HTS', 'hypertonic saline'] @entity19794 :: ('MESH:D019354', 'Chemical') :: ['sodium lactate']
@entity2656 :: (MESH:D008353,Chemical) :: ['Mannitol']
