Effects of Hypertonic Sodium Lactate on Intracranial Pressure in Patients with Traumatic Brain Injury: A Systematic Review and Metanalysis on Clinical Trial Studies

R. Mosaed, Arash Akhavan Rezayat, Behnaz Rohani, Aida Ayati Afin, F. Najmeddin, Shahideh Amini, Maryam Taghizadeh-Ghehi, Mohamad Afshar Ardalan, A. Najafi, M. Mojtahedzadeh
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Abstract

Introduction: Intracranial pressure (ICP) elevation leading to cerebral edema is a critical condition that should be identified and treated immediately. In this study, we systematically reviewed the articles investigating the role of hypertonic sodium lactate (HSL) in patients with traumatic brain injury. Method: PubMed, Scopus, EMBASE, and Web of Science were searched to find published articles on the effects of HSL on ICP in patients with a traumatic brain injury until December 2020. Animal studies, case reports, and studies, including liver and renal failure patients, cardiac dysfunction, or hypovolemic shock, were excluded. The Newcastle–Ottawa Scale checklist was used to assess the methodological quality of eligible articles. Information was gathered based on the following: Demographic data, methods, intervention, and outcomes. Results: Our initial search with the predefined search strategy proceeded 113 studies. Finally, seven studies were eligible for systematic review, which three of them were eligible for meta-analysis. A random meta-analysis of three articles comparing ICP before and after the infusion of HSL showed a reduced ICP following the use of HSL in traumatic brain injuries (P=0.015). Conclusion: Our study demonstrated hypertonic sodium lactate's undeniable role in managing increased ICP in patients with brain injury. Nevertheless, conducting more clinical studies for assessing the possible side effects of HSL seems crucial.
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高渗乳酸钠对外伤性脑损伤患者颅内压的影响:临床试验研究的系统回顾和荟萃分析
颅内压(ICP)升高导致脑水肿是一种危重疾病,应立即发现并治疗。在本研究中,我们系统地回顾了研究高渗乳酸钠(HSL)在创伤性脑损伤患者中的作用的文章。方法:检索PubMed、Scopus、EMBASE和Web of Science,查找截至2020年12月关于HSL对颅脑损伤患者ICP影响的已发表文章。排除了动物研究、病例报告和研究,包括肝肾衰竭患者、心功能障碍或低血容量性休克。使用纽卡斯尔-渥太华量表检查表评估符合条件的文章的方法学质量。收集的信息基于以下方面:人口统计数据、方法、干预措施和结果。结果:我们使用预定义的搜索策略进行了113项研究。最后,有7项研究符合系统评价的要求,其中3项符合荟萃分析的要求。对三篇比较HSL输注前后颅内压的随机荟萃分析显示,颅内压在颅脑外伤中使用HSL后降低(P=0.015)。结论:我们的研究证明了高渗乳酸钠在处理颅脑损伤患者颅内压增高中不可否认的作用。然而,进行更多的临床研究来评估HSL可能的副作用似乎至关重要。
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