Abstract: Objective To study the effects of different concentrations of hypertonic saline (HS) and 20% mannitol on decreasing intracranial pressure (ICP) in patients with moderate-sever traumatic brain injury (TBI). Methods A total of 60 patients were randomly assigned into 7.5% HS group, 3% HS group and 20% mannitol group, 20 patients in each group. All of patients were treated with conventional treatment according to the diagnostic and treatment practices of TBI. When ICP was above 20 mmHg for more than 5 minutes, patients were administered corresponding hypertonic dehydrator. The levels of ICP, mean arterial pressure (MAP), cerebral perfusion pressure (CPP), urine volume per hour and serum sodium were monitored continuously within 6 hours after the initiation of therapy. Results All agents could significantly decrease the ICP (P < 0.05), but the onset time in 7.5% HS group was less than that of the other two groups (P < 0.05), and the decreased magnitude of ICP and the effective time of decreasing ICP in 7.5% HS group were more than those of the other two groups (P < 0.05). Both 7.5%HS and 3%HS could increase MAP and CPP. There was no statistical difference in serum sodium between both groups , but the diuretic effect in both groups was worse than that of 20% mannitol group. Conclusion The rapidly infusion of 7.5% HS could significantly decrease the ICP, increase the MAP and CPP without obvious side-effect in patients with moderate- sever TBI, and which is a safe and effective therapy for intracranial hypertension after traumatic brain injury．

Key words: craniocerebral trauma, saline solution, hypertonic, mannitol, intracranial pressure, diuresis, mean arterial pressure, cerebral perfusion pressure