AI Summary & Key Takeaways
AI InsightFurther studies evaluating the efficacy and side effects of hyperosmolar treatment procedures are needed, especially in the childhood age group.
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Özet
Introduction: Trauma that occurs during childhood is a leading preventable health problem worldwide. The aim of this study was to compare the epidemiological characteristics, trauma etiologies, treatment procedures, efficacy, and side effects of 3% hypertonic saline and mannitol treatment for patients in a pediatric intensive care unit with the diagnosis of traumatic brain injury (TBI) or brain edema. Methods: The files of 35 patients with the diagnosis of TBI or brain edema were reviewed retrospectively. Patients were divided into 3 groups according to the brain edema treatment procedure applied. Group 1 comprised patients who received only 3% hypertonic saline, patients who received both hypertonic saline and mannitol were included in Group 2, and Group 3 was made up of those who received only mannitol. Patients were also categorized according to their admission Glasgow Coma Score (GCS). Results: Sixteen (45.7%) of the 35 patients were female and 19 (54.3%) were male. An evaluation of complications that developed in the course of treatment revealed that renal failure was the most frequent, observed in 17 patients (48.6%). Of the 17 patients who developed renal failure, 14 (82.4%) were evaluated as severe TBI based on GCS, which was statistically significant (p=0.004). When the brain edema treatment of these 17 patients was examined, there was statistical significance in the finding that 15 (88.2%) of the patients had received mannitol (p=0.037). The serum urea and creatinine levels of patients who developed renal failure were found to be positively correlated with the number of mannitol doses received (r=0.784; p=0.001). Discussion and Conclusion: Hypertonic saline alone or in combination with mannitol is used in the treatment of brain edema. The present findings suggest that 3% hypertonic saline is safer in hyperosmolar treatment of traumatic brain injury and that mannitol should be used with caution, especially in young patients. Further studies evaluating the efficacy and side effects of hyperosmolar treatment procedures are needed, especially in the childhood age group.