Mannitol reduces optic nerve sheath diameter and ICP in traumatic brain injury patients

This prospective cohort study enrolled 71 patients with traumatic brain injury admitted to the Neurocritical Care Unit of the First People’s Hospital of Changde. The intervention involved dynamic monitoring of optic nerve sheath diameter (ONSD) and mannitol infusion, with comparisons made before and 20 minutes after mannitol administration. The primary outcome was the relationship between ONSD and intracranial pressure (ICP).

Main results showed that ONSD decreased from 6.39 (6.13, 6.73) mm to 4.94 (4.71, 5.61) mm (p = 0.021), and ICP decreased from 35 (32, 41) mmHg to 21 (17, 28) mmHg (p = 0.010). No effect sizes or absolute numbers were reported for these changes. The study did not assess secondary outcomes.

Safety and tolerability data, including adverse events, serious adverse events, and discontinuations, were not reported. Limitations were not specified in the input, but the observational cohort design and lack of a control group beyond pre-infusion measurements constrain causal conclusions. Funding and conflicts of interest were not reported.

Practice relevance was not reported, but the findings may inform clinicians about short-term ONSD and ICP reductions with mannitol in this setting. However, the evidence is preliminary due to the single-center, observational nature and absence of safety data, warranting cautious interpretation in clinical decision-making.