{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T19:59:43Z","timestamp":1793735983847,"version":"4.6.1"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Mannitol is often used to reduce cerebral edema in acute intracerebral hemorrhage but without strong supporting evidence of benefit. We aimed to determine the impact of mannitol on outcome among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>INTERACT2 was an international, open, blinded end point, randomized controlled trial of 2839 patients with spontaneous intracerebral hemorrhage (&lt;6 hours) and elevated systolic blood pressure allocated to intensive (target systolic blood pressure, &lt;140 mm\u2009Hg within 1 hour) or guideline-recommended (target systolic blood pressure, &lt;180 mm\u2009Hg) blood pressure\u2013lowering treatment. Propensity score and multivariable analyses were performed to investigate the relationship between mannitol treatment (within 7 days) and poor outcome, defined by death or major disability on the modified Rankin Scale score (3\u20136) at 90 days.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              There was no significant difference in poor outcome between mannitol (n=1533) and nonmannitol (n=993) groups: propensity score\u2013matched odds ratio of 0.90 (95% confidence interval, 0.75\u20131.09;\n              <jats:italic>P<\/jats:italic>\n              =0.30) and multivariable odds ratio of 0.87 (95% confidence interval, 0.71\u20131.07;\n              <jats:italic>P<\/jats:italic>\n              =0.18). Although a better outcome was suggested in patients with larger (\u226515 mL) than those with smaller (&lt;15 mL) baseline hematomas who received mannitol (odds ratio, 0.52 [95% confidence interval, 0.35\u20130.78] versus odds ratio, 0.91 [95% confidence interval, 0.72\u20131.15];\n              <jats:italic>P<\/jats:italic>\n              homogeneity &lt;0.03 in propensity score analyses), the association was not consistent in analyses across other cutoff points (\u226510 and \u226520 mL) and for differing grades of neurological severity. Mannitol was not associated with excess serious adverse events.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Mannitol seems safe but might not improve outcome in patients with acute intracerebral hemorrhage.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00716079.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.115.009357","type":"journal-article","created":{"date-parts":[[2015,8,12]],"date-time":"2015-08-12T02:39:52Z","timestamp":1439347192000},"page":"2762-2767","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":60,"title":["Mannitol and Outcome in Intracerebral Hemorrhage"],"prefix":"10.1161","volume":"46","author":[{"given":"Xia","family":"Wang","sequence":"first","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisatomi","family":"Arima","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yang","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihong","family":"Zhang","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guojun","family":"Wu","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Woodward","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Mu\u00f1oz-Venturelli","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo M.","family":"Lavados","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Stapf","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thompson","family":"Robinson","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Heeley","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candice","family":"Delcourt","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard I.","family":"Lindley","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Parsons","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Chalmers","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig S.","family":"Anderson","sequence":"additional","affiliation":[{"name":"From The George Institute for Global Health, School of Public Health, the University of Sydney, Sydney, Australia (X.W., H.A., M.W., P.M.-V., E.H., C.D., R.I.L., J.C., C.S.A.); Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (C.D., C.S.A.); Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China (J.Y.); Department of Neurology, West China Hospital, Sichuan University, Chengdu, China (S.Z.); Department of Neurology, Hebei Yutian Hospital,..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","first-page":"762","article-title":"Management of elevated intracranial pressure.","volume":"9","author":"Woster PS","year":"1990","unstructured":"Woster PS, LeBlanc KL. 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Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association. Stroke. 2015;46:2032\u20132060. doi: 10.1161\/STR.0000000000000069.","DOI":"10.1161\/STR.0000000000000069"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000078658.52316.E8"},{"key":"e_1_3_3_8_2","first-page":"48","article-title":"The use of mannitol in intracerebral bleeds in the medical ICU.","volume":"88","author":"Gigliuto CM","year":"1991","unstructured":"Gigliuto CM, Stone KE, Algus M. The use of mannitol in intracerebral bleeds in the medical ICU. N J Med. 1991;88:48\u201351.","journal-title":"N J Med"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2004.05.019"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2005.03.038"},{"key":"e_1_3_3_11_2","first-page":"CD001153","article-title":"Mannitol for acute stroke.","volume":"3","author":"Bereczki D","year":"2007","unstructured":"Bereczki D, Fekete I, Prado GF, Liu M. Mannitol for acute stroke. Cochrane Database Syst Rev2007;3:CD001153.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214609"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2010.00415.x"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.20.6.828"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.07.021"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.113.000359"},{"key":"e_1_3_3_18_2","unstructured":"Lanehart RE Rodriguez de Gil P Kim ES Bellara AP Kromrey JD Lee RS. Propensity score analysis and assessment of propensity score approaches using SAS procedures. SAS Web site. http:\/\/support.sas.com\/resources\/papers\/proceedings12\/314\u20132012.pdf. Acceesed April 22 2012."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e318173fc99"},{"key":"e_1_3_3_20_2","doi-asserted-by":"crossref","unstructured":"Heeley E Anderson CS Woodward M Arima H Robinson T Stapf C et al.. Poor utility of grading scales in acute intracerebral hemorrhage: Results from the INTERACT2 trial [published online ahead of print June 4 2015]. Int J Stroke. http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ijs.12518\/epdf. Accessed June 4 2015.","DOI":"10.1111\/ijs.12518"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01403005"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008506-199301000-00001"},{"key":"e_1_3_3_23_2","first-page":"359","article-title":"Clinical study of mannitol and glycerol on raised intracranial pressure and on their rebound phenomenon.","volume":"52","author":"Node Y","year":"1990","unstructured":"Node Y, Nakazawa S. 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