Randomised controlled trials (RCTs), quasi- and non-randomised trials, cohort studies, case control studies, before and after studies, case series and case report studies that studied osmotic agents in children (up to 16 years) with acute traumatic and non-traumatic encephalopathies were eligible for inclusion. Relevant outcomes were reduction in intracranial pressure, resolution of coma, neurological sequelae and death.
The included studies considered saline, urea, sorbitol, glycerol (with or without dexamethasone) or mannitol in children with acute encephalopathies such as raised intracranial pressure, non-traumatic encephalopathies, traumatic brain injuries, acute bacterial meningitis and cerebral malaria. Control (where used) was either Ringer's lactate or placebo. Studies were in Kenya, Uganda, USA, Germany, South America, Switzerland and India.
The authors did not state how many reviewers performed study selection.