Soluciones hipertónicas en trauma craneoencefálico: revisión sistemática de la literatura

Abstract

Traumatic Brain Injury is the silent epidemic disease actually, and generates spent of health costs about 60 billion dollars per year, and almost 400 billion dollars in rehabilitation in survivors. The cornerstone, in the treatment of moderate and severe traumatic brain injury, is the Osmotherapy, mainly with substances like Mannitol and Hypertonic Solutions. It was made the research of 14 databases, finding 4657754 articles, leaving 40 trials after an exhaustive analysis, that they were related with intracranial hypertension and osmotic therapy. Comparing the different articles, it was found a great variability in the type of trials without homogenization about statistical analysis, and the lack of stringency, that not allowed the meta-analysis, so the realization of a systematic review of the literature was decided. It was evidenced three things mainly: first, is the lack of stringency how the clinical trials were made; second, it was the deficiency of multicentric random clinical trials, that could give the solid evidence and scientific validity is required, despite the clear evidence in clinical practice; the third is the security for their use with low presence of complications for hypertonic saline solutions.