A meta-analysis of 7. 5% hypertonic saline contrast mannitol in reducing the intracranial hypertension

Objective Meta-analysis was used to compare the effect of 7.5% hypertonic saline and mannitol in reducing intracranial pressure,in order to provide reference for clinical application. Methods Cochrane Library,PubMed,Medline,Academic Search Premier,the China Biological Medicine Database,CNKI,VIP and Wanfang Database were retrieved.The related literature about randomized controlled trials of comparing intracranial hypertension by 7.5% hypertonic saline and the mannitol from the establishment of databases to January 2016 were collected.Literature screening,data extraction and assessment of methodological quality were retrieved in accordance with the method of a systematic review of evidenced-based medicine.RevMan 5.3 software was used to conduct meta-analysis for each indicator. Results Totally 10 articles were enrolled,including 447 patients,with 226 in the 7.5% HS group and the other 221 in the mannitol group.The value of ICP after the intervention of HS group was lower than the mannitol group(P=0.020),and the maintenance time was longer than the mannitol group as well(P=0.004).There was no significant difference in the CVP,plasma osmotic pressure and the serum sodium after the intervention.The MAP level of HS group was lower than the mannitol group. Conclusion In reducing intracranial pressure 7.5% HS and mannitol are effective and have longer duration,but the effect of maintaining the MAP is not as good as that of mannitol.