Magnesium sulfate for acute traumatic brain injury.
BACKGROUND
The purpose of this systematic review was to evaluate the effect of magnesium sulfate in the treatment of acute traumatic brain injury.


METHODS
A systematic search of ClinicalTrials.gov, the Cochrane Library database, EMBASE, MEDLINE, Web of Science, and the World Health Organization trial registry, plus manual searches of gray literature, was undertaken in April 2013. Two reviewers independently extracted the data with a predefined data extraction form. RevMan 5 software was used to synthesize data and calculate the risk ratio for mortality with the 95% confidence interval. For the Glasgow Outcome Scale and posttreatment Glasgow Coma Scale data, the weighted mean difference was calculated with the 95% confidence interval.


RESULTS
A total of 8 randomized controlled trials with a total of 786 patients were included. Meta-analysis showed that there was no significant difference between the groups for mortality. The Glasgow Outcome Scale of the treatment group was higher than that of the control group, although the significance was borderline. The Glasgow Coma Scale score change posttreatment was significantly higher than that of the control.


CONCLUSIONS
The present meta-analysis of existing randomized controlled trials does not identify a significant beneficial effect in the mortality of traumatic brain injury patients; however, it suggests that magnesium sulfate shows a tendency to improve the Glasgow Outcome Scale and Glasgow Coma Scale scores, which is a promising result for traumatic brain injury therapy. Further effort is necessary to explore which subgroup of traumatic brain injury patients could benefit from magnesium sulfate.
From the *Department of Neurosurgery, First Affiliated Hospital of Xi'an Medical University; and †Department of Neurosurgery, First Affiliated Hospital, Medical College of Xi'an Jiaotong University, Shaanxi, China.
Wen
W
Li
Yin-An
YA
Bai
Ya-Jun
YJ
Li
Kai-Ge
KG
Liu
Mao-De
MD
Wang
Gang-Zhu
GZ
Xu
Hong-Li
HL
Shang
Yan-Feng
YF
Li
D001930:Brain Injuries / Q000188:drug therapy*; D002423:Cause of Death; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D015996:Survival Rate
D018696:Neuroprotective Agents; D008278:Magnesium Sulfate