Cochrane review from 2014: Mannitol versus hypertonic saline for brain relaxation in patients undergoing craniotomy. By Prabhakar et al. “From the limited data available on the use of mannitol and hypertonic saline for brain relaxation during craniotomy, it is suggested that hypertonic saline significantly reduces the risk of tense brain during craniotomy”
In this commentary in Critical Care 2012 Dr. Nicholas Marko argues in favour of choosing HS over mannitol in management of intracranial hypertension.
Well written overview of ICP-management and the role of hyperosmolar therapy. By Ropper, 2014. The chapter comparing hypertonic saline and mannitol is particularly interesting.
Just off the press: Cochrane Collaboration Review of the use of therapeutic hypothermia after cardiopulmonary resuscitation. “Evidence of moderate quality suggests that conventional cooling methods provided to induce mild therapeutic hypothermia improve neurological outcome after cardiac arrest, specifically with better outcomes than occur with no temperature management” The updated Cochrane review goes a long way… Continue reading Cochrane Review – Hypothermia for Neuroprotection after Cardiac Arrest
“…treatment with mannitol may increase the likelihood of death when compared to treatment with hypertonic saline.” Read the Cochrane review from 2013: Mannitol for acute traumatic brain injury.
Life in The Fast Lane´s take on the use of ketamine in traumatic brain injury. Nice summary of available literature. Sums it up succinctly for those who are still reluctant to use ketamine in this patient group. For more on the same subject, see this article on ketamine and ICP.
The excellent reviewers at The Bottom Line are taking a thorough look at the STITCH (Trauma) trial of 2015. The STITCH (Trauma) trial (Early Surgery versus Initial Conservative Treatment in Patients with Traumatic Intracerebral Hemorrhage) recruited 170 patients into a multicenter RCT to determine whether early surgery (within 12 hours) for traumatic intracerebral haemorrhage would confer a mortality benefit… Continue reading The Bottom Line – The STITCH Trial
Listen to the podcast here. More about TBI and end tidal carbon dioxide/ PaCO2. Normocapnia and hyperventilation. Adjust the ventilation until end tidal CO2 is 4,7, then take an ABG… Use mannitol and “the patients will pee like race horses…”
Updates in Traumatic Brain Injury, 2015. Joseph R. Shiber MD. Dr. Shiber is an Associate Professor of the Departments of Emergency Medicine and Surgical Critical Care; is the Co-Director of the Neuroscience ICU; and acts as a regular Intensivist in the SICU/TICU at the University of Florida College of Medicine. In this podcast, several clinical… Continue reading Nice lecture on TBI by Prof. Shiber
Be quiet and listen here. Visit neurotrauma.org.uk for more ! Podcasts/ videos from the october 15 Neurotrauma symposium in London. Several talks. 6 months. Nice.
neuroscand.com 