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

Sujita W. Narayan, Ronald Castelino, Naomi Hammond, Asad E. Patanwala

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)220-224
Number of pages5
JournalJournal of Critical Care
Volume57
DOIs
StatePublished - Jun 2020

Keywords

  • (MeSH): Hypertonic saline
  • Acute kidney injury
  • Mannitol
  • Traumatic brain injury

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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