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Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial
BACKGROUND: Several reports have suggested that raised intracranial pressure (ICP) is a major contributor to death among children with cerebral malaria. Mannitol, an osmotic diuretic, effectively lowers ICP and is used to treat post-traumatic raised ICP. It is not clear whether intravenous mannitol...
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2007
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2147028/ https://www.ncbi.nlm.nih.gov/pubmed/17958887 http://dx.doi.org/10.1186/1475-2875-6-138 |
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author | Namutangula, Beatrice Ndeezi, Grace Byarugaba, Justus S Tumwine, James K |
author_facet | Namutangula, Beatrice Ndeezi, Grace Byarugaba, Justus S Tumwine, James K |
author_sort | Namutangula, Beatrice |
collection | PubMed |
description | BACKGROUND: Several reports have suggested that raised intracranial pressure (ICP) is a major contributor to death among children with cerebral malaria. Mannitol, an osmotic diuretic, effectively lowers ICP and is used to treat post-traumatic raised ICP. It is not clear whether intravenous mannitol given to children with cerebral malaria improves clinical outcome. The objective of this study was to determine the effect of mannitol as adjunct therapy on the clinical outcome of children with cerebral malaria. METHODS: This randomized double-blind placebo controlled clinical trial was carried out at the Emergency Paediatric ward of Mulago Hospital, Uganda's national referral and teaching hospital. One hundred and fifty six children aged 6 to 60 months with cerebral malaria were randomized to either one dose of mannitol 1 g/kg or placebo, in addition to intravenous quinine. Main outcome measures included coma recovery time; time to sit unsupported, begin oral intake; duration of hospitalization; death and adverse effects. RESULTS: Time to regain consciousness (p = 0.11), sit unsupported (p = 0.81), time to start oral intake (p = 0.13) and total coma duration (p = 0.07) were similar in both groups. There was no significant difference in the mortality between the placebo (13/80 or 16.3%) and mannitol (10/76 or 13.2%) groups: RR = 1.2 (CI 0.5–2.7). No adverse effects were observed after administration of mannitol. CONCLUSION: Mannitol had no significant impact on clinical outcome of cerebral malaria. It is difficult to recommend intravenous mannitol as adjunct therapy for childhood cerebral malaria. CLINICAL REGISTRATION NUMBER: ClinicalTrials.gov ID: NCT00113854 |
format | Text |
id | pubmed-2147028 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2007 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-21470282007-12-19 Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial Namutangula, Beatrice Ndeezi, Grace Byarugaba, Justus S Tumwine, James K Malar J Research BACKGROUND: Several reports have suggested that raised intracranial pressure (ICP) is a major contributor to death among children with cerebral malaria. Mannitol, an osmotic diuretic, effectively lowers ICP and is used to treat post-traumatic raised ICP. It is not clear whether intravenous mannitol given to children with cerebral malaria improves clinical outcome. The objective of this study was to determine the effect of mannitol as adjunct therapy on the clinical outcome of children with cerebral malaria. METHODS: This randomized double-blind placebo controlled clinical trial was carried out at the Emergency Paediatric ward of Mulago Hospital, Uganda's national referral and teaching hospital. One hundred and fifty six children aged 6 to 60 months with cerebral malaria were randomized to either one dose of mannitol 1 g/kg or placebo, in addition to intravenous quinine. Main outcome measures included coma recovery time; time to sit unsupported, begin oral intake; duration of hospitalization; death and adverse effects. RESULTS: Time to regain consciousness (p = 0.11), sit unsupported (p = 0.81), time to start oral intake (p = 0.13) and total coma duration (p = 0.07) were similar in both groups. There was no significant difference in the mortality between the placebo (13/80 or 16.3%) and mannitol (10/76 or 13.2%) groups: RR = 1.2 (CI 0.5–2.7). No adverse effects were observed after administration of mannitol. CONCLUSION: Mannitol had no significant impact on clinical outcome of cerebral malaria. It is difficult to recommend intravenous mannitol as adjunct therapy for childhood cerebral malaria. CLINICAL REGISTRATION NUMBER: ClinicalTrials.gov ID: NCT00113854 BioMed Central 2007-10-24 /pmc/articles/PMC2147028/ /pubmed/17958887 http://dx.doi.org/10.1186/1475-2875-6-138 Text en Copyright © 2007 Namutangula et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Namutangula, Beatrice Ndeezi, Grace Byarugaba, Justus S Tumwine, James K Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title | Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title_full | Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title_fullStr | Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title_full_unstemmed | Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title_short | Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial |
title_sort | mannitol as adjunct therapy for childhood cerebral malaria in uganda: a randomized clinical trial |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2147028/ https://www.ncbi.nlm.nih.gov/pubmed/17958887 http://dx.doi.org/10.1186/1475-2875-6-138 |
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