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

Pubmed ID: 32220771

Journal: Journal of critical care

Publication Date: June 1, 2020

Affiliation: The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia; Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. Electronic address: asad.patanwala@sydney.edu.au.

MeSH Terms: Humans, Male, Adult, Female, Adolescent, Middle Aged, Hospitalization, Propensity Score, Treatment Outcome, Young Adult, Prospective Studies, Creatinine, Incidence, Retrospective Studies, Glomerular Filtration Rate, Risk, Acute Kidney Injury, Creatine, Outcome Assessment, Health Care, Brain Injuries, Traumatic, Mannitol, Resuscitation, Saline Solution, Hypertonic

Authors: Narayan SW, Castelino R, Hammond N, Patanwala AE

Cite As: Narayan SW, Castelino R, Hammond N, Patanwala AE. Effect of mannitol plus hypertonic saline combination versus hypertonic saline monotherapy on acute kidney injury after traumatic brain injury. J Crit Care 2020 Jun;57:220-224. Epub 2020 Mar 19.

Studies:

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.