Faculty Sponsor

Jana Stedman

College

College of Nursing & Health Professions (CONHP)

Department/Program

Physician Assistant Program

Presentation Type

Poster Presentation

Symposium Date

Summer 7-23-2025

Abstract

Abstract

Objective: To evaluate whether mannitol or hypertonic saline (HS) is associated with a lower mortality rate in the management of increased intracranial pressure (ICP) in patients with traumatic brain injuries (TBI).

Methods: A systematic literature search was conducted using Google Scholar and the Valparaiso University Library database to identify studies comparing mannitol and hypertonic saline in the treatment of elevated ICP due to TBI. Search terms included variations of “mannitol,” “hypertonic saline,” “intracranial pressure,” “traumatic brain injury,” and “mortality.” A total of 3,280 results were retrieved from an initial Google Scholar search, 2,350 from a more specific follow-up search, and 507 from the Valparaiso Library database. Inclusion criteria were: English-language studies published since 2019, full-text availability, patient population with TBI-induced increased ICP, comparison of mannitol versus hypertonic saline, and mortality as a measured outcome. Studies were excluded if they did not meet these criteria.

Results: The review found no significant difference in mortality between mannitol and hypertonic saline in the treatment of increased ICP in TBI patients across most studies. However, a post-hoc sensitivity analysis by Schwimmbeck et al. reported a statistically significant reduction in mortality with hypertonic saline, though this was not a consistent finding across the broader literature.

Conclusion: Current evidence does not demonstrate a clear mortality benefit of either mannitol or hypertonic saline in the management of elevated ICP due to TBI. Further research with larger sample sizes, standardized outcome measures, and rigorous subgroup analyses is needed to definitively guide clinical decision-making.

Biographical Information about Author(s)

Abigail Gemeinhart has a special interest in neurology and plans on working at Franciscan hospital in the neurology department following graduation. She will be presenting on “Mortality Outcomes in Traumatic Brain Injury: Mannitol vs. Hypertonic Saline” because she has a special interest in outcomes following neurologic injuries.

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