Eficacia de la solución salina hipertónica frente al manitol en pacientes adultos con trauma craneoencefálico grave: revisión sistemática

Severe traumatic brain injury (TBI) is the leading cause of disability and mortality worldwide, and hyperosmolar solutions have been used to treat it without a standardized choice. The efficacy of hypertonic saline solution (HSS) was compared with mannitol (MTL) in adult patients with severe or potentially severe moderate TBI, evaluating the decrease in intracranial pressure, level of consciousness, and serum osmolarity concentration to identify whether one is superior to the other. Nine articles that met the established inclusion and exclusion criteria were included, with a total of 979 participants and sample sizes ranging from 20 to 502; the bias of the articles was analyzed using scales. HHS is superior in terms of efficacy compared to LTM due to its sustained mechanism of action over time and lower recurrence of episodes of intracranial hypertension.