Overview

The goal of this prospective multi-center observational study is to learn about the osmotic therapy in severe subarachnoid hemorrhage (SAH). The main question[s] it aims to answer are:

• whether the two osmotic therapy, 20% mannitol and 10% hypertonic saline(HTS), under the same osmotic equivalent, has similar influence on the outcome of SAH patients?

Participants will be given proper treatment according to local expert consensus, including the choice of osmotic medicine. Investigators just record and analyse the data, compare mannitol group and HTS group to see if the outcome of latter is not worse than the former.

Eligibility

Inclusion Criteria:

• ①age ≥18； ②CT confirmed subarachnoid hemorrhage; ③Hunt-Hess 3-5级

Exclusion Criteria:

• previous decompressive craniectomy, a leakage or a drainage of cerebrospinal fluid, bilateral fixed and dilated pupils, unstable hemodynamic conditions, oliguric renal failure, hemoglobin < 8g/L, serum osmolality> 320 mOsm/L, combined with serious dysfunction of organs such as heart, lung, liver, and kidney; combined with severe electrolyte disturbances (especially serum sodium concentration <125 mmol/L or >170 mmol/L) and blood gas dysfunction, which are difficult to correct in a short time；use of hypertonic treatment within 6h; pregnant.