Included studies1-150
| Study | Participants | Intervention | Number randomised | Allocation concealment | ||||
|---|---|---|---|---|---|---|---|---|
| Hyperventilation: | ||||||||
| Muizelaar et al 12 | Patients with head injuries Glasgow coma score (GCS)⩽8, age 3 years or older | Hyperventilation: paco2 25 ± 2 mm Hg | 77 | Sealed opaque envelopes | ||||
| Normoventilation: paco2 35 ± 2 mm Hg | ||||||||
| Mannitol: | ||||||||
| Sayre et al 13 | Intubated head trauma victims GCS⩽12, age 18 years or more before arrival in hospital | Mannitol: 5 ml/kg 20% mannitol as rapidly as possible | 44 randomised: 3 postrandomisation exclusions because did not meet all | Pharmacy prepared blinded solutions | ||||
| Control: 5 ml/kg 0.9% NaCl prerandomisation inclusion criteria | ||||||||
| CSF drainage: | ||||||||
| No randomised trials identified | ||||||||
| Barbiturates: | ||||||||
| Eisenberg et al 17 | Severe head injury GCS⩽7 Aged 15–50, raised intracranial pressure (ICP) refractory to conventional management | Pentobarbitone: loading dose 10 mg/kg over 30 min 5 mg/kg every hour for three hours | 80 randomised: 7 postrandomisation exclusions because did not meet all prerandomisation inclusion criteria | Sealed opaque envelopes | ||||
| Maintenance 1 mg/kg/h with serum concentration monitoring | ||||||||
| Ward et al 18 | Consecutive head injured patients over the age of 12 years who had either an acute intradural haematoma or no mass lesion whose best motor response was abnormal flexion or extension. Treatment started after head injury regardless of ICP | Pentobarbitone: loading dose 5–10 mg/kg until burst suppression on EEG | 53 | Not specified | ||||
| Maintenance 1–3 mg/kg with serum concentration monitoring | ||||||||
↵1-150 A detailed description of randomised trials of steroids in head injury has been presented elsewhere.