Hypertonic saline and mannitol are staples in the management of elevated intracranial pressure, but how well do we understand their mechanisms, and what does the evidence actually support? Are we improving patient outcomes, or simply improving a number?
In this episode, we break down the physiology of osmotherapy, compare hypertonic saline and mannitol, and explore their role in traumatic brain injury and other neurologic emergencies. We’ll examine the research, discuss prehospital considerations, and review practical interventions to optimize cerebral perfusion. We’ll challenge common assumptions, highlight the limitations of the available evidence, and discuss what it means for clinical practice.
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