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Results of Hypertonic Saline or Mannitol Clinical Trial for Treatment of Children with Severe TBI

OPENPediatrics via YouTube

Overview

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This course discusses the ADAPT trial comparing hypertonic saline with mannitol for reducing intracranial pressure in children with severe traumatic brain injury. It covers the trial design, key outcomes, study limitations, and implications for pediatric TBI management.

Syllabus

- Kochanek PM, Adelson PD, Rosario BL, et al. Comparison of Intracranial Pressure Measurements Before and After Hypertonic Saline or Mannitol Treatment in Children With Severe Traumatic Brain Injury. JAMA Netw Open. 2022;53:e220891. Published 2022 Mar 1. doi:10.1001/jamanetworkopen.2022.0891
- Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest [published correction appears in N Engl J Med 2002 May 30;34622:1756]. N Engl J Med. 2002;3468:549-556. doi:10.1056/NEJMoa012689
- Kochanek PM, Tasker RC, Carney N, et al. Guidelines for the Management of Pediatric Severe Traumatic Brain Injury, Third Edition: Update of the Brain Trauma Foundation Guidelines [published correction appears in Pediatr Crit Care Med. 2019 Apr;204:404]. Pediatr Crit Care Med. 2019;203S Suppl 1:S1-S82. doi:10.1097/PCC.0000000000001735
- Khanna S, Davis D, Peterson B, et al. Use of hypertonic saline in the treatment of severe refractory posttraumatic intracranial hypertension in pediatric traumatic brain injury. Crit Care Med. 2000;284:1144-1151. doi:10.1097/00003246-200004000-00038
- Kumar SA, Devi BI, Reddy M, Shukla D. Comparison of equiosmolar dose of hyperosmolar agents in reducing intracranial pressure-a randomized control study in pediatric traumatic brain injury. Childs Nerv Syst. 2019;356:999-1005. doi:10.1007/s00381-019-04121-3
- Polderman KH. Mechanisms of action, physiological effects, and complications of hypothermia. Crit Care Med. 2009;377 Suppl:S186-S202. doi:10.1097/CCM.0b013e3181aa5241

Taught by

OPENPediatrics

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