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Indian Journal of Surgery, Vol. 69, No. 1, January-February, 2007, pp. 35-36 Letter To Editor Reply to clinical trials comparing high dose and conventional dose mannitol in the treatment of head injury Roberts Ian London School of Hygiene and Tropical Medicine,Keppel Street, London WC1E 7HT Code Number: is07015 Sir, Between 2001 and 2004, three reports were published by Dr. Julio Cruz and colleagues presenting the results of three clinical trials comparing high dose and conventional dose mannitol in the treatment of head injury.[1],[2],[3] They appeared to show that high dose mannitol was dramatically effective in reducing death and disability after head injury. The trials were included in a systematic review of the effectiveness of mannitol in head injury and published in the Cochrane Library in July 2005. The review concluded that "high dose mannitol appears to be preferable to conventional dose mannitol in the acute management of comatose patients with severe head injury." The Cochrane Injuries Group later discovered that there were concerns about these trials and an investigation was made the results of which are available on the CRASH-2 website (www.crash2.lshtm.ac.uk). We know that mannitol is widely used in the management of patients with head trauma and felt that readers should be made aware of the Injuries Group investigation as soon as possible. References
Copyright 2007 - Indian Journal of Surgery |
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