The effect of hypertonic saline in traumatic brain injury: A systematic review

Abstract

Traumatic brain injury (TBI) causes mortality and long-term disability among young adults and imposes a notable cost on the healthcare system. In addition to the first physical hit, secondary injury, which is associated with increased intracranial pressure (IPC), is defined as biochemical, cellular, and physiological changes after the physical injury. This systematic review and meta-analysis, evaluates the effectiveness of Hypertonic saline (HTS) in the management of patients with TBI.

Methods: This study was conducted following the Joanna Briggs Institute (JBI) methods and PRISMA statement. A systematic search was performed through six databases including PubMed, EMBASE, Scopus, ProQuest, Google Scholar, and Web of Science in February 2022, to find studies that evaluated the effects of HTS, on increased IPC. Meta-analysis was performed using the comprehensive meta-analysis (CMA).

Results: Out of 1321 results, 8 studies were included in the systematic review, and 3 of them were included in the quantitative synthesis. The results of meta-analysis reached a 35.9% (95% CI=15.0-56.9) reduction in ICP in TBI patients receiving HTS, with no significant risk of publication bias (t-value=0.38, df=2, p-value=0.73). The most common source of bias in our included studies was the transparency of blinding methods for both patients and outcome assessors.