Effects of Hypertonic Sodium Lactate on Intracranial Pressure in Patients with Traumatic Brain Injury: A Systematic Review and Metanalysis on Clinical Trial Studies

Abstract

Introduction: Intracranial pressure (ICP) elevation leading to cerebral edema is a critical condition that should be identified and treated immediately. In this study, we systematically reviewed the articles investigating the role of hypertonic sodium lactate (HSL) in patients with traumatic brain injury. Method: PubMed, Scopus, EMBASE, and Web of Science were searched to find published articles on the effects of HSL on ICP in patients with a traumatic brain injury until December 2020. Animal studies, case reports, and studies, including liver and renal failure patients, cardiac dysfunction, or hypovolemic shock, were excluded. The Newcastle–Ottawa Scale checklist was used to assess the methodological quality of eligible articles. Information was gathered based on the following: Demographic data, methods, intervention, and outcomes. Results: Our initial search with the predefined search strategy proceeded 113 studies. Finally, seven studies were eligible for systematic review, which three of them were eligible for meta-analysis. A random meta-analysis of three articles comparing ICP before and after the infusion of HSL showed a reduced ICP following the use of HSL in traumatic brain injuries (P=0.015). Conclusion: Our study demonstrated hypertonic sodium lactate's undeniable role in managing increased ICP in patients with brain injury. Nevertheless, conducting more clinical studies for assessing the possible side effects of HSL seems crucial.