• Massimo Lamperti, Francisco A Lobo, and Boris Tufegdzic.
• Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
• Curr Opin Anaesthesiol. 2022 Oct 1; 35 (5): 555561555-561.

Purpose Of ReviewThe aim of this review article is to present current recommendations regarding the use of hypertonic saline and mannitol for the treatment of intracranial hypertension.Recent FindingsIn recent years, a significant number of studies have been published comparing hypertonic saline with mannitol in patients with acute increased intracranial pressure, mostly caused by traumatic brain injury. Albeit several randomized controlled trials, systematic reviews and meta-analysis support hypertonic saline as more effective than mannitol in reducing intracranial pressure, no clear benefit in regards to the long-term neurologic outcome of these patients has been reported.SummaryIdentifying and treating increased intracranial pressure is imperative in neurocritical care settings and proper management is essential to improve long-term outcomes. Currently, there is insufficient evidence from comparative studies to support a formal recommendation on the use of any specific hyperosmolar medication in patients with acute increased intracranial pressure.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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