• Sujita W Narayan, Ronald Castelino, Naomi Hammond, and Asad E Patanwala.
• The University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, New South Wales, Australia. Electronic address: sujita.narayan@sydney.edu.au.
• J Crit Care. 2020 Jun 1; 57: 220-224.

PurposeTo compare the effect of mannitol plus hypertonic saline combination (MHS) versus hypertonic saline monotherapy (HS) on renal function in patients with traumatic brain injury (TBI).Materials And MethodsThis was a secondary analysis of data from the Resuscitation Outcomes Consortium Hypertonic Saline Trial Shock Study and Traumatic Brain Injury Study. The study cohort included a propensity matched subset of patients with TBI who received MHS or HS. The primary outcome measure was the maximum serum creatinine value during critical illness.ResultsThe cohort consisted of 163 patients in the MHS group and 163 patients in the HS group (n = 326). The maximum serum creatinine value during hospitalization was 82 ± 47 μmol/L (0.86 ± 0.26 mg/dL) in the MHS group and 76 ± 23 μmol/L (0.92 ± 0.53 mg/dL) in the HS group (difference -6 μmol/L, 95% CI -14 to 2 μmol/L, p = .151). The lowest eGFR during hospitalization was 108 ± 25 mL/min in the MHS group and 112 ± 24 mL/min in the HS group (difference -4 mL/min, 95% CI -1 to 9 mLmin, p = .150).ConclusionsThe addition of mannitol to HS did not increase the risk of renal dysfunction compared to HS alone in patients with TBI.Copyright © 2020 Elsevier Inc. All rights reserved.

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