Mannitol in acute traumatic brain injury
2002; Elsevier BV; Volume: 359; Issue: 9318 Linguagem: Inglês
10.1016/s0140-6736(02)08545-8
ISSN1474-547X
AutoresRudolph J. Schrot, J. Paul Muizelaar,
Tópico(s)Cerebrospinal fluid and hydrocephalus
ResumoNeurosurgery may boast very high technology in surgical art, but when it comes to validating practice, as neurosurgeon Stephen Haines, 1 Haines SJ History of randomised clinical trials in neurosurgery. Neurosurg Clin N Am. 2001; 12: 211-216 PubMed Google Scholar put it, "we evaluate our practice with 1920s techniques". Haines goes on to say that the traditional method consists of "observation, review, theory formation, and treatment alteration", whereas the modern approach relies on concurrent comparison, objective observation, and random allocation. 1 Haines SJ History of randomised clinical trials in neurosurgery. Neurosurg Clin N Am. 2001; 12: 211-216 PubMed Google Scholar Randomised controlled trials are still sorely needed in neurosurgery, and a recent publication by Julio Cruz and colleagues 2 Cruz J Minoja G Okuchi K The novel clinical benefits of emergency megadose mannitol for rapidly deteriorating patients with bilaterally unreactive pupils: a randomised trial. Neurosurgery. 2001; 49: 864-871 PubMed Google Scholar describing the dose-response effect of preoperative mannitol on acute subdural haematomas is an important contribution to the evidence base in traumatic brain injury.
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