effects of hypertonic sodium lactate on intracranial pressure in patients with traumatic brain injury: a systematic review and meta-analysis on clinical trial studies

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 (tbi). methods: pubmed, scopus, embase, and web of science were searched to find published articles on the effects of hsl on icp in patients with a tbi until december 2020. animal studies, case reports, and studies, including patients with liver and renal failure, cardiac dysfunction, or hypovolemic shock, were excluded. the newcastle-ottawa scale checklist was used to assess the methodological quality of eligible articles. information obtained was classified based on the following criteria: demographic data, methods, intervention, and outcomes. results: our initial search with the predefined search strategy proceeded with 113 studies. finally, 7 studies were eligible for systematic review, and 3 of them were eligible for meta-analysis. a random meta-analysis of 3 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 the undeniable role of hsl in managing increased icp in patients with brain injury. nevertheless, conducting more clinical studies to assess the possible side effects of hsl seems crucial.