Stroke: no clear role for mannitol given acutely

Clinical bottom line (level 1a-)

  1. The effect of giving mannitol to patients with a recent stroke is unclear.
Bereczki et al: Cochrane Library 2001; 1 : -
Expires November 2003

The study

Systematic review of all randomised controlled trials of
  • Patients: within 2 weeks of acute ischaemic stroke or parenchymal haemorrhage
  • Intervention: mannitol compared with placebo or open control
  • Outcome: death, disability

    Articles found in all languates using Cochrane Stroke Group Specialised Trials Register, Medline, Chinese Stroke Trials Register, LILACs, to June 2000 (search terms: detailed in text )

    Selection criteria: by 2 independent reviewers - see above
    Appraisal criteria: by 2 independent reviewers: based on ramdomisation, blinding, loss to follow-up, intention-to-treat analysis
    Articles excluded if:

    1 trial found involving 77 patients with 55% follow-up at 10 days

    The evidence

    Outcome Time to outcome CER OR
    (95% CI)    		 NNT
    (95% CI)
    improvement in clinical condition 10 days 23/41
    (56.1%)    		 0.98
    (0.4 to 2.4)     		200
    (NNT = 4 to infinity;
    NNH = 5 to infinity)

    Citation

    1. Bereczki D, Liu M, do Prado GF, et al: mannitol for acute stroke. Cochrane Library 2001; 1 : -
    Search Terms: stroke in Cochrane Library
    Contributor: Chris Ball, November 2001
    Reviewer:

    Clinical Question.
    Patient acute stroke
    Intervention or Exposure mannitol
    Comparison control or placebo
    Outcome death, disability
    		•