Salin Hipertonik VS Manitol untuk Menurunkan Tekanan Intrakranial pada Cedera Otak Traumatik

Oleh :

dr. Andriani Putri Bestari, Sp.S

Salin hipertonik dan manitol sering digunakan untuk menurunkan tekanan intrakranial (TIK) pada kasus cedera otak traumatik. Pemilihan antara kedua cairan ini bergantung pada kondisi pasien dan preferensi fasilitas kesehatan di mana pasien dirawat.[1]

Cedera otak traumatik dapat dibedakan menjadi cedera primer dan sekunder. Cedera primer berkaitan dengan proses trauma langsung pada parenkim serebral seperti kontusio dan cedera aksonal. Sedangkan, cedera sekunder berkaitan erat dengan peningkatan TIK yang disebabkan oleh inflamasi fokal hingga iskemia global.[1,2]

Tata laksana cedera otak traumatik bertujuan untuk menurunkan TIK. Terapi cairan, baik menggunakan salin hipertonik atau manitol, merupakan salah satu modalitas tata laksana TIK pada cedera otak traumatik.[1,2]

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1.Viarasilpa, T. Managing Intracranial Pressure Crisis. Curr Neurol Neurosci Rep 25, 12. 2025. https://doi.org/10.1007/s11910-024-01392-5
2.Janich K, Nguyen HS, et al. Management of adult traumatic brain injury: A review. Journal of Trauma and Treatment. 2016;5(3).
3. Arifianto MR, Ma'ruf AZ, et al. Efficacy comparison of manitol and hypertonic saline for Traumatic Brain Injury (TBI) treatment. Bali Medical Journal. 2016;5(3):516-521.
4. Abou El Fadl MH, et al. Management of traumatic brain injury: an update. Neurosurgery Clinics. 2018;29(2):213-221.
5. Farrokh S, Cho SM, et al. Fluids and hyperosmolar agents in neurocritical care: an update. Current opinion in critical care. 2019;25(2):105-109.
6. Alnemari AM, Krafcik BM, et al. A comparison of pharmacologic therapeutic agents used for the reduction of intracranial pressure after traumatic brain injury. World neurosurgery. 2017; 106:509-528.
7. Witherspoon B, Ashby NE. The use of manitol and hypertonic saline therapies in patients with elevated intracranial pressure: A review of the evidence. Nursing Clinics. 2017;52(2):249-260.
8. Boone MD, Oren-Grinberg A, et al. Manitol or hypertonic saline in the setting of traumatic brain injury: what have we learned?. Surgical neurology international. 2015;6.
9. Burgess S, Abu-Laban RB, et al. A systematic review of randomized controlled trials comparing hypertonic sodium solutions and manitol for traumatic brain injury: implications for emergency department management. Annals of Pharmacotherapy. 2016;50(4):291-300.
10. Gu J, Huang H, et al. Hypertonic saline or manitol for treating elevated intracranial pressure in traumatic brain injury: a meta-analysis of randomized controlled trials. Neurosurgical review. 2019;42(2):499-509.
11. Chen H, Song Z, et al. Hypertonic saline versus other intracranial pressure–lowering agents for people with acute traumatic brain injury. Cochrane Database of Systematic Reviews 2020, Issue 1. Art. No.: CD010904. DOI: 10.1002/14651858.CD010904.pub3.
12. Chong S, Zhu Y, et al. Clinical Outcomes of Hypertonic Saline vs Mannitol Treatment Among Children With Traumatic Brain Injury. JAMA Netw Open. 2025;8(3):e250438. doi:10.1001/jamanetworkopen.2025.0438