Effect of mannitol plus hypertonic saline combination versus hypertonic saline monotherapy on acute kidney injury after traumatic brain injury.

Abstract

PURPOSE:

To compare the effect of mannitol plus hypertonic saline combination (MHS) versus hypertonic saline monotherapy (HS) on renal function in patients with traumatic brain injury (TBI).

MATERIALS AND METHODS:

This was a secondary analysis of data from the Resuscitation Outcomes Consortium Hypertonic Saline Trial Shock Study and Traumatic Brain Injury Study. The study cohort included a propensity matched subset of patients with TBI who received MHS or HS. The primary outcome measure was the maximum serum creatinine value during critical illness.

RESULTS:

The cohort consisted of 163 patients in the MHS group and 163 patients in the HS group (n = 326). The maximum serum creatinine value during hospitalization was 82 ± 47 μmol/L (0.86 ± 0.26 mg/dL) in the MHS group and 76 ± 23 μmol/L (0.92 ± 0.53 mg/dL) in the HS group (difference -6 μmol/L, 95% CI -14 to 2 μmol/L, p = .151). The lowest eGFR during hospitalization was 108 ± 25 mL/min in the MHS group and 112 ± 24 mL/min in the HS group (difference -4 mL/min, 95% CI -1 to 9 mLmin, p = .150).

CONCLUSIONS:

The addition of mannitol to HS did not increase the risk of renal dysfunction compared to HS alone in patients with TBI.

• Authors: Sujita W Narayan, Ronald Castelino, Naomi Hammond, Asad E Patanwala
• Journal: Journal of critical care (J Crit Care) Vol. 57 Pg. 220-224 (06 2020) ISSN: 1557-8615 [Electronic] United States
• PMID: 32220771 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Chemical References

• Saline Solution, Hypertonic
• Mannitol
• Creatinine
• Creatine

Topics

• Acute Kidney Injury (complications, therapy)
• Adolescent
• Adult
• Brain Injuries, Traumatic (complications, therapy)
• Creatine (blood)
• Creatinine (blood)
• Female
• Glomerular Filtration Rate
• Hospitalization
• Humans
• Incidence
• Male
• Mannitol (administration & dosage)
• Middle Aged
• Outcome Assessment, Health Care
• Propensity Score
• Prospective Studies
• Resuscitation
• Retrospective Studies
• Risk
• Saline Solution, Hypertonic (administration & dosage)
• Treatment Outcome
• Young Adult