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Abstract
Objective: To explore
the effectiveness of commonly
used dosing for mannitol (MN)
compared with hypertonic saline
solution (HSS) in children
with elevated intracranial
pressure (ICP) due to diabetic
ketoacidosis (DKA), head trauma,
or acute central nervous system
(CNS) infections.
Methods:
We followed the Preferred
Reporting Items for Systematic
Reviews and Meta-Analyses
(PRISMA) guidelines. A structured
literature review was carried
out using the component of
the PICO framework. The literature
search was conducted in Medline,
Ovid, Embase, Google Scholar,
and PubMed. A combination
of relevant search terms was
used. Electronic searches
were supplemented by manual
searches of references of
included studies and review
articles. The duplicate citations
were identified and removed.
Results:
A total of 169 articles were
identified through the searches,
while 8 articles met the inclusion
criteria. The characteristics
and results of included studies
were discussed, regarding
the study design, sample size,
and outcome.
Conclusions:
Osmotic agents, such as HSS
and MN are commonly used in
the management of high ICP.
HSS (3% or 7.5%) has superior
therapeutic effects over MN
(20%) in lowering increased
ICP in children with cerebral
edema.
Key
Words: Cerebral edema,
Increased intracranial pressure,
Children, Osmotic agents,
Mannitol, hypertonic saline
solution, systematic review,
PRISMA.
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