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Efficacy Comparison of Mannitol and Hypertonic Saline for Traumatic Brain Injury (TBI) Treatment

Muhammad Reza Arifianto , Achmad Zuhro Ma'ruf, Arie Ibrahim

Muhammad Reza Arifianto
Kanudjoso Djatiwibowo Hospital, Balikpapan, East Borneo, Indonesia. Email: mrezaarif@yahoo.com

Achmad Zuhro Ma'ruf
Department of Neurosurgery, Kanudjoso Djatiwibowo Hospital, Balikpapan-Indonesia

Arie Ibrahim
Department of Neurosurgery, AW Syahranie Hospital / Faculty of Medicine, Mulawarman University, Samarinda-Indonesia
Online First: November 01, 2016 | Cite this Article
Arifianto, M., Ma'ruf, A., Ibrahim, A. 2016. Efficacy Comparison of Mannitol and Hypertonic Saline for Traumatic Brain Injury (TBI) Treatment. Bali Medical Journal 5(3): 516-521. DOI:10.15562/bmj.v5i3.281


Traumatic Brain Injury (TBI) case is commonly found in the emergency room.  TBI accompanied by increased intracranial pressure (ICP) is a neurological emergency that requires prompt and appropriate management. Hyperosmolar fluid is the main treatment in the initial management of increased ICP. Mannitol and hypertonic saline are hyperosmolar fluids which are generally used. There is no specific recommendation regarding the choice between the two fluids. From the current studies indicate that both fluids are equally effective in reducing ICP. Regarding the superiority between the two fluids, it is difficult to determine because of the heterogeneity of the studies that exist. Therefore, clinicians should choose between hyperosmolar fluids based on indications and contraindications exist in TBI patients.

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