Mannitol and other osmotic diuretics as adjuncts for treating cerebral malaria

Abstract

There are insufficient data to know what the effects of osmotic diuretics are in children with cerebral malaria. Larger, multicentre trials are needed.

Hypothyroidism confers tolerance to cerebral malaria

“…4B ). Mannitol has been proposed as an adjuvant to treat brain edema in CM ( 41 ). However, daily administration of mannitol, starting the day of infection, did not increase survival and did not modify the clinical score in infected euthyroid and hyperthyroid mice.…”

Hypothyroidism confers tolerance to cerebral malaria

“…4B ). Mannitol has been proposed as an adjuvant to treat brain edema in CM ( 41 ). However, daily administration of mannitol, starting the day of infection, did not increase survival and did not modify the clinical score in infected euthyroid and hyperthyroid mice.…”

Brain Swelling and Mannitol Therapy in Adult Cerebral Malaria: A Randomized Trial

“…Mannitol is an osmotic active drug that can lower intracranial pressure by absorbing extracellular fluid into the vascular compartment. Its use in cerebral malaria is common and has been advocated by several authors, but adequately powered randomized clinical trials have thus far been lacking [ 11 ]. Our results indicate that mannitol cannot be recommended as an adjunctive treatment in adult patients with cerebral malaria and may be harmful.…”

Contrasting pediatric and adult cerebral malaria

“…Mannitol, an osmotic diuretic agent to reduce brain swelling, did not improve outcomes in African children with CM, 136 although this small trial may have been under-powered to detect a true effect. 146 Likewise, mortality was not reduced and duration of coma was in fact prolonged in adult patients in India who received mannitol as adjunctive therapy. 139 Similarly, older studies investigating the use of dexamethasone to reduce cerebral edema did not demonstrate clinical efficacy.…”

Hypothyroidism confers tolerance to cerebral malaria

“…4B ). Mannitol has been proposed as an adjuvant to treat brain edema in CM ( 41 ). However, daily administration of mannitol, starting the day of infection, did not increase survival and did not modify the clinical score in infected euthyroid and hyperthyroid mice.…”

Brain Swelling and Mannitol Therapy in Adult Cerebral Malaria: A Randomized Trial

“…Mannitol is an osmotic active drug that can lower intracranial pressure by absorbing extracellular fluid into the vascular compartment. Its use in cerebral malaria is common and has been advocated by several authors, but adequately powered randomized clinical trials have thus far been lacking [ 11 ]. Our results indicate that mannitol cannot be recommended as an adjunctive treatment in adult patients with cerebral malaria and may be harmful.…”

Contrasting pediatric and adult cerebral malaria

“…Mannitol, an osmotic diuretic agent to reduce brain swelling, did not improve outcomes in African children with CM, 136 although this small trial may have been under-powered to detect a true effect. 146 Likewise, mortality was not reduced and duration of coma was in fact prolonged in adult patients in India who received mannitol as adjunctive therapy. 139 Similarly, older studies investigating the use of dexamethasone to reduce cerebral edema did not demonstrate clinical efficacy.…”

Hypothyroidism confers tolerance to cerebral malaria

“…4B ). Mannitol has been proposed as an adjuvant to treat brain edema in CM ( 41 ). However, daily administration of mannitol, starting the day of infection, did not increase survival and did not modify the clinical score in infected euthyroid and hyperthyroid mice.…”

Brain Swelling and Mannitol Therapy in Adult Cerebral Malaria: A Randomized Trial

“…Mannitol is an osmotic active drug that can lower intracranial pressure by absorbing extracellular fluid into the vascular compartment. Its use in cerebral malaria is common and has been advocated by several authors, but adequately powered randomized clinical trials have thus far been lacking [ 11 ]. Our results indicate that mannitol cannot be recommended as an adjunctive treatment in adult patients with cerebral malaria and may be harmful.…”

Contrasting pediatric and adult cerebral malaria

“…Mannitol, an osmotic diuretic agent to reduce brain swelling, did not improve outcomes in African children with CM, 136 although this small trial may have been under-powered to detect a true effect. 146 Likewise, mortality was not reduced and duration of coma was in fact prolonged in adult patients in India who received mannitol as adjunctive therapy. 139 Similarly, older studies investigating the use of dexamethasone to reduce cerebral edema did not demonstrate clinical efficacy.…”