Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury
Importance: The use of hypertonic saline (HTS) vs mannitol in the control of elevated intracranial pressure (ICP) secondary to neurotrauma is debated. Objective: To compare mortality and functional outcomes of treatment with 3% HTS vs 20% mannitol among children with moderate to severe traumatic bra...
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| author | Shu‐Ling Chong Yanan Zhu Quan Wang Paula Caporal Juan D. Roa Freddy Israel Pantoja Chamorro Thelma Elvira Terán Miranda Hongxing Dang Chin Seng Gan Qalab Abbas Ivan J. Ardila Mohannad Antar Jesús Domínguez-Rojas María Miñambres Rodríguez Natalia Zita Watzlawik Natalia Elizabeth Gómez Arriola Adriana Yock‐Corrales Rubén Eduardo Lasso Palomino Ming Mei Xiu Jacqueline Soo May Ong Hiroshi Kurosawa Gabriela Aparicio Chun‐Feng Liu Rujipat Samransamruajkit Juan Camilo Jaramillo-Bustamante Nattachai Anantasit Yek Kee Chor Deborah M. Turina Pei Chuen Lee Marisol Fonseca Flores J. Pilar Orive Jing Wen Sebastián González‐Dambrauskas Jan Hau Lee Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) Yasser Kazzaz Jian Ji Suyun Qian Lijia Fan Olive Pei Ee Lee Soo Lin Chuah Kai You Tao Zhang Deiby Lasso Noguera Esteban Cerón Andrea Leal Barceló Susana Reyes Cesia J Ortega Ocas |
| author_browse | Adriana Yock‐Corrales Andrea Leal Barceló Cesia J Ortega Ocas Chin Seng Gan Chun‐Feng Liu Deborah M. Turina Deiby Lasso Noguera Esteban Cerón Freddy Israel Pantoja Chamorro Gabriela Aparicio Hiroshi Kurosawa Hongxing Dang Ivan J. Ardila J. Pilar Orive Jacqueline Soo May Ong Jan Hau Lee Jesús Domínguez-Rojas Jian Ji Jing Wen Juan Camilo Jaramillo-Bustamante Juan D. Roa Kai You Lijia Fan Marisol Fonseca Flores María Miñambres Rodríguez Ming Mei Xiu Mohannad Antar Natalia Elizabeth Gómez Arriola Natalia Zita Watzlawik Nattachai Anantasit Olive Pei Ee Lee Paula Caporal Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) Pei Chuen Lee Qalab Abbas Quan Wang Rubén Eduardo Lasso Palomino Rujipat Samransamruajkit Sebastián González‐Dambrauskas Shu‐Ling Chong Soo Lin Chuah Susana Reyes Suyun Qian Tao Zhang Thelma Elvira Terán Miranda Yanan Zhu Yasser Kazzaz Yek Kee Chor |
| author_facet | Shu‐Ling Chong Yanan Zhu Quan Wang Paula Caporal Juan D. Roa Freddy Israel Pantoja Chamorro Thelma Elvira Terán Miranda Hongxing Dang Chin Seng Gan Qalab Abbas Ivan J. Ardila Mohannad Antar Jesús Domínguez-Rojas María Miñambres Rodríguez Natalia Zita Watzlawik Natalia Elizabeth Gómez Arriola Adriana Yock‐Corrales Rubén Eduardo Lasso Palomino Ming Mei Xiu Jacqueline Soo May Ong Hiroshi Kurosawa Gabriela Aparicio Chun‐Feng Liu Rujipat Samransamruajkit Juan Camilo Jaramillo-Bustamante Nattachai Anantasit Yek Kee Chor Deborah M. Turina Pei Chuen Lee Marisol Fonseca Flores J. Pilar Orive Jing Wen Sebastián González‐Dambrauskas Jan Hau Lee Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) Yasser Kazzaz Jian Ji Suyun Qian Lijia Fan Olive Pei Ee Lee Soo Lin Chuah Kai You Tao Zhang Deiby Lasso Noguera Esteban Cerón Andrea Leal Barceló Susana Reyes Cesia J Ortega Ocas |
| author_sort | Shu‐Ling Chong |
| collection | Producción científica |
| description | Importance: The use of hypertonic saline (HTS) vs mannitol in the control of elevated intracranial pressure (ICP) secondary to neurotrauma is debated. Objective: To compare mortality and functional outcomes of treatment with 3% HTS vs 20% mannitol among children with moderate to severe traumatic brain injury (TBI) at risk of elevated ICP. Design, Setting, and Participants: This prospective, multicenter cohort study was conducted between June 1, 2018, and December 31, 2022, at 28 participating pediatric intensive care units in the Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) in Asia, Latin America, and Europe. The study included children (aged <18 years) with moderate to severe TBI (Glasgow Coma Scale [GCS] score ≤13). Exposure: Treatment with 3% HTS compared with 20% mannitol. Main Outcomes and Measures: Multiple log-binomial regression analysis was performed for mortality, and multiple linear regression analysis was performed for discharge Pediatric Cerebral Performance Category (PCPC) scores and 3-month Glasgow Outcome Scale-Extended Pediatric Version (GOS-E-Peds) scores. Inverse probability of treatment weighting was also performed using the propensity score method to control for baseline imbalance between groups. Results: This study included 445 children with a median age of 5.0 (IQR, 2.0-11.0) years. More than half of the patients (279 [62.7%]) were boys, and 344 (77.3%) had severe TBI. Overall, 184 children (41.3%) received 3% HTS, 82 (18.4%) received 20% mannitol, 69 (15.5%) received both agents, and 110 (24.7%) received neither agent. The mortality rate was 7.1% (13 of 184 patients) in the HTS group and 11.0% (9 of 82 patients) in the mannitol group (P = .34). After adjusting for age, sex, presence of child abuse, time between injury and hospital arrival, lowest GCS score in the first 24 hours, and presence of extradural hemorrhage, no between-group differences in mortality, hospital discharge PCPC scores, or 3-month GOS-E-Peds scores were observed. Conclusions and Relevance: In this cohort study of children with moderate to severe TBI, the use of HTS was not associated with increased survival or improved functional outcomes compared with mannitol. Future large multicenter randomized clinical trials are required to validate these findings. |
| format | Article |
| id | oai:cris.upeu.edu.pe:20.500.15037/1352 |
| institution | UPeU |
| language | English |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| record_format | dspace |
| spelling | oai:cris.upeu.edu.pe:20.500.15037/13522026-10-30T16:15:38ZClinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain InjuryShu‐Ling ChongYanan ZhuQuan WangPaula CaporalJuan D. RoaFreddy Israel Pantoja ChamorroThelma Elvira Terán MirandaHongxing DangChin Seng GanQalab AbbasIvan J. ArdilaMohannad AntarJesús Domínguez-RojasMaría Miñambres RodríguezNatalia Zita WatzlawikNatalia Elizabeth Gómez ArriolaAdriana Yock‐CorralesRubén Eduardo Lasso PalominoMing Mei XiuJacqueline Soo May OngHiroshi KurosawaGabriela AparicioChun‐Feng LiuRujipat SamransamruajkitJuan Camilo Jaramillo-BustamanteNattachai AnantasitYek Kee ChorDeborah M. TurinaPei Chuen LeeMarisol Fonseca FloresJ. Pilar OriveJing WenSebastián González‐DambrauskasJan Hau LeePediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed)Yasser KazzazJian JiSuyun QianLijia FanOlive Pei Ee LeeSoo Lin ChuahKai YouTao ZhangDeiby Lasso NogueraEsteban CerónAndrea Leal BarcelóSusana ReyesCesia J Ortega OcasMedicineGlasgow Coma ScaleHypertonic salineTraumatic brain injuryPediatricsIntensive careAnesthesiaIntensive care medicinePsychiatryMedicineGlasgow Coma ScaleHypertonic salineTraumatic brain injuryPediatricsIntensive careAnesthesiaIntensive care medicinePsychiatryBrain Injuries, Traumatic complicationsBrain Injuries, Traumatic complicationsBrain Injuries, Traumatic complicationsBrain Injuries, Traumatic complicationsBrain Injuries, Traumatic complicationsBrain Injuries, Traumatic complicationsBrain Injuries, Traumatic complicationsBrain Injuries, Traumatic drug therapyBrain Injuries, Traumatic drug therapyBrain Injuries, Traumatic drug therapyBrain Injuries, Traumatic drug therapyBrain Injuries, Traumatic drug therapyBrain Injuries, Traumatic drug therapyBrain Injuries, Traumatic drug therapyBrain Injuries, Traumatic mortalityBrain Injuries, Traumatic mortalityBrain Injuries, Traumatic mortalityBrain Injuries, Traumatic mortalityBrain Injuries, Traumatic mortalityBrain Injuries, Traumatic mortalityBrain Injuries, Traumatic mortalityAdolescentAdolescentAdolescentAdolescentAdolescentAdolescentAdolescentAsia epidemiologyAsia epidemiologyChildChildChildChildChildChildChildChild, PreschoolChild, PreschoolChild, PreschoolChild, PreschoolChild, PreschoolChild, PreschoolChild, PreschoolDiuretics, Osmotic therapeutic useDiuretics, Osmotic therapeutic useDiuretics, Osmotic therapeutic useDiuretics, Osmotic therapeutic useDiuretics, Osmotic therapeutic useDiuretics, Osmotic therapeutic useDiuretics, Osmotic therapeutic useEuropeEuropeEuropeEuropeEuropeEuropeEuropeFemaleFemaleFemaleFemaleFemaleFemaleFemaleHumansHumansHumansHumansHumansHumansHumansInfantInfantLatin AmericaLatin AmericaMaleMaleMaleMaleMaleMaleMaleMannitol therapeutic useMannitol therapeutic useMannitol therapeutic useMannitol therapeutic useMannitol therapeutic useMannitol therapeutic useMannitol therapeutic useProspective StudiesProspective StudiesProspective StudiesProspective StudiesProspective StudiesProspective StudiesProspective StudiesSaline Solution, Hypertonic therapeutic useSaline Solution, Hypertonic therapeutic useSaline Solution, Hypertonic therapeutic useSaline Solution, Hypertonic therapeutic useSaline Solution, Hypertonic therapeutic useSaline Solution, Hypertonic therapeutic useSaline Solution, Hypertonic therapeutic useGlasgow Coma ScaleGlasgow Coma ScaleGlasgow Coma ScaleGlasgow Coma ScaleGlasgow Coma ScaleGlasgow Coma ScaleGlasgow Coma ScaleTreatment OutcomeTreatment OutcomeTreatment OutcomeTreatment OutcomeTreatment OutcomeTreatment OutcomeTreatment OutcomeIntracranial Hypertension drug therapyIntracranial Hypertension drug therapyIntracranial Hypertension drug therapyIntracranial Hypertension drug therapyIntracranial Hypertension drug therapyIntracranial Hypertension drug therapyIntracranial Hypertension drug therapyIntracranial Hypertension etiologyIntracranial Hypertension etiologyIntracranial Hypertension etiologyIntracranial Hypertension etiologyIntracranial Hypertension etiologyIntracranial Hypertension etiologyIntracranial Hypertension etiologyHealth Sciences Medicine Neurology Traumatic Brain Injury and Neurovascular DisturbancesHealth Sciences Medicine Critical Care and Intensive Care Medicine Trauma, Hemostasis, Coagulopathy, ResuscitationHealth Sciences Medicine Emergency Medicine Cardiac Arrest and ResuscitationImportance: The use of hypertonic saline (HTS) vs mannitol in the control of elevated intracranial pressure (ICP) secondary to neurotrauma is debated. Objective: To compare mortality and functional outcomes of treatment with 3% HTS vs 20% mannitol among children with moderate to severe traumatic brain injury (TBI) at risk of elevated ICP. Design, Setting, and Participants: This prospective, multicenter cohort study was conducted between June 1, 2018, and December 31, 2022, at 28 participating pediatric intensive care units in the Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) in Asia, Latin America, and Europe. The study included children (aged <18 years) with moderate to severe TBI (Glasgow Coma Scale [GCS] score ≤13). Exposure: Treatment with 3% HTS compared with 20% mannitol. Main Outcomes and Measures: Multiple log-binomial regression analysis was performed for mortality, and multiple linear regression analysis was performed for discharge Pediatric Cerebral Performance Category (PCPC) scores and 3-month Glasgow Outcome Scale-Extended Pediatric Version (GOS-E-Peds) scores. Inverse probability of treatment weighting was also performed using the propensity score method to control for baseline imbalance between groups. Results: This study included 445 children with a median age of 5.0 (IQR, 2.0-11.0) years. More than half of the patients (279 [62.7%]) were boys, and 344 (77.3%) had severe TBI. Overall, 184 children (41.3%) received 3% HTS, 82 (18.4%) received 20% mannitol, 69 (15.5%) received both agents, and 110 (24.7%) received neither agent. The mortality rate was 7.1% (13 of 184 patients) in the HTS group and 11.0% (9 of 82 patients) in the mannitol group (P = .34). After adjusting for age, sex, presence of child abuse, time between injury and hospital arrival, lowest GCS score in the first 24 hours, and presence of extradural hemorrhage, no between-group differences in mortality, hospital discharge PCPC scores, or 3-month GOS-E-Peds scores were observed. Conclusions and Relevance: In this cohort study of children with moderate to severe TBI, the use of HTS was not associated with increased survival or improved functional outcomes compared with mannitol. Future large multicenter randomized clinical trials are required to validate these findings.Articlehttps://pubmed.ncbi.nlm.nih.gov/40067302https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2831220/chong_2025_oi_250039_1741025143.58236.pdfhttps://doi.org/10.1001/jamanetworkopen.2025.043810.1001/jamanetworkopen.2025.0438https://hdl.handle.net/20.500.15037/1352W4408331063enJAMA Network Open2574-38052025-03-112026-06-13T09:54:40Z2026-06-13T09:54:40Z |
| spellingShingle | Medicine Glasgow Coma Scale Hypertonic saline Traumatic brain injury Pediatrics Intensive care Anesthesia Intensive care medicine Psychiatry Medicine Glasgow Coma Scale Hypertonic saline Traumatic brain injury Pediatrics Intensive care Anesthesia Intensive care medicine Psychiatry Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Adolescent Adolescent Adolescent Adolescent Adolescent Adolescent Adolescent Asia epidemiology Asia epidemiology Child Child Child Child Child Child Child Child, Preschool Child, Preschool Child, Preschool Child, Preschool Child, Preschool Child, Preschool Child, Preschool Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Europe Europe Europe Europe Europe Europe Europe Female Female Female Female Female Female Female Humans Humans Humans Humans Humans Humans Humans Infant Infant Latin America Latin America Male Male Male Male Male Male Male Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Health Sciences Medicine Neurology Traumatic Brain Injury and Neurovascular Disturbances Health Sciences Medicine Critical Care and Intensive Care Medicine Trauma, Hemostasis, Coagulopathy, Resuscitation Health Sciences Medicine Emergency Medicine Cardiac Arrest and Resuscitation Shu‐Ling Chong Yanan Zhu Quan Wang Paula Caporal Juan D. Roa Freddy Israel Pantoja Chamorro Thelma Elvira Terán Miranda Hongxing Dang Chin Seng Gan Qalab Abbas Ivan J. Ardila Mohannad Antar Jesús Domínguez-Rojas María Miñambres Rodríguez Natalia Zita Watzlawik Natalia Elizabeth Gómez Arriola Adriana Yock‐Corrales Rubén Eduardo Lasso Palomino Ming Mei Xiu Jacqueline Soo May Ong Hiroshi Kurosawa Gabriela Aparicio Chun‐Feng Liu Rujipat Samransamruajkit Juan Camilo Jaramillo-Bustamante Nattachai Anantasit Yek Kee Chor Deborah M. Turina Pei Chuen Lee Marisol Fonseca Flores J. Pilar Orive Jing Wen Sebastián González‐Dambrauskas Jan Hau Lee Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) Yasser Kazzaz Jian Ji Suyun Qian Lijia Fan Olive Pei Ee Lee Soo Lin Chuah Kai You Tao Zhang Deiby Lasso Noguera Esteban Cerón Andrea Leal Barceló Susana Reyes Cesia J Ortega Ocas Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury |
| title | Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury |
| title_full | Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury |
| title_fullStr | Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury |
| title_full_unstemmed | Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury |
| title_short | Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury |
| title_sort | clinical outcomes of hypertonic saline vs mannitol treatment among children with traumatic brain injury |
| topic | Medicine Glasgow Coma Scale Hypertonic saline Traumatic brain injury Pediatrics Intensive care Anesthesia Intensive care medicine Psychiatry Medicine Glasgow Coma Scale Hypertonic saline Traumatic brain injury Pediatrics Intensive care Anesthesia Intensive care medicine Psychiatry Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Adolescent Adolescent Adolescent Adolescent Adolescent Adolescent Adolescent Asia epidemiology Asia epidemiology Child Child Child Child Child Child Child Child, Preschool Child, Preschool Child, Preschool Child, Preschool Child, Preschool Child, Preschool Child, Preschool Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Europe Europe Europe Europe Europe Europe Europe Female Female Female Female Female Female Female Humans Humans Humans Humans Humans Humans Humans Infant Infant Latin America Latin America Male Male Male Male Male Male Male Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Health Sciences Medicine Neurology Traumatic Brain Injury and Neurovascular Disturbances Health Sciences Medicine Critical Care and Intensive Care Medicine Trauma, Hemostasis, Coagulopathy, Resuscitation Health Sciences Medicine Emergency Medicine Cardiac Arrest and Resuscitation |
| topic_facet | Medicine Glasgow Coma Scale Hypertonic saline Traumatic brain injury Pediatrics Intensive care Anesthesia Intensive care medicine Psychiatry Medicine Glasgow Coma Scale Hypertonic saline Traumatic brain injury Pediatrics Intensive care Anesthesia Intensive care medicine Psychiatry Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic complications Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic drug therapy Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Brain Injuries, Traumatic mortality Adolescent Adolescent Adolescent Adolescent Adolescent Adolescent Adolescent Asia epidemiology Asia epidemiology Child Child Child Child Child Child Child Child, Preschool Child, Preschool Child, Preschool Child, Preschool Child, Preschool Child, Preschool Child, Preschool Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Diuretics, Osmotic therapeutic use Europe Europe Europe Europe Europe Europe Europe Female Female Female Female Female Female Female Humans Humans Humans Humans Humans Humans Humans Infant Infant Latin America Latin America Male Male Male Male Male Male Male Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Mannitol therapeutic use Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Prospective Studies Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Saline Solution, Hypertonic therapeutic use Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Glasgow Coma Scale Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Treatment Outcome Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension drug therapy Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Intracranial Hypertension etiology Health Sciences Medicine Neurology Traumatic Brain Injury and Neurovascular Disturbances Health Sciences Medicine Critical Care and Intensive Care Medicine Trauma, Hemostasis, Coagulopathy, Resuscitation Health Sciences Medicine Emergency Medicine Cardiac Arrest and Resuscitation |
| url | https://pubmed.ncbi.nlm.nih.gov/40067302 https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2831220/chong_2025_oi_250039_1741025143.58236.pdf https://doi.org/10.1001/jamanetworkopen.2025.0438 https://hdl.handle.net/20.500.15037/1352 |
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