Hypertonic Saline For The Treatment Of Severe Craniocerebral Injury And Shock:a Meta-analysis

Objective:To compare the efficacy of 7.5% hypertonic saline(HS)and 20% mannitol in the treatment of severe craniocerebral injury with shock.Methods:The Chinese Biomedical Literature Database(CBM),China Knowledge Network(CNKI),Weipu,Wanfang and Pub Med databases were searched by computer.The search time was until November 2018.Screening and data extraction were performed by 2researchers and Meta-analysis of each indicator was performed using Revman 5.3software?Results:A total of 7 articles were included in the meta-analysis.The results showed that the intracranial pressure level in the HS group was lower than mannitol(P<0.05),the cerebral perfusion pressure level was higher than mannitol(P<0.05),and the heart rate level was lower than mannitol(P <0.05),urinary production level was lower than mannitol(P<0.05),mortality within 24 h was lower than mannitol(P<0.05),and total mortality was lower in HS group(P<0.05),the mean arterial pressure level was no significant difference between the HS group and the mannitol group(P>0.05)?Conclusion:According to the current META analysis results,7.5% hypertonic saline is superior to 20% mannitol in reducing intracranial pressure,improving cerebral perfusion and improving vital signs of shock fluid resuscitation;7.5% hypertonic saline also improves patients' Survival rate,but still need further prospective,large-sample RCT to verify,but also provide new rescue ideas for future critically ill patients with anti-shock and intracranial pressure reduction.