A Cochrane review included 11 studies. Analysis of death during the scheduled treatment period was possible in 10 trials (n=945). Glycerol was associated with a non-significant reduction in the odds of death (odds Ratio [OR] 0.78, 95% confidence interval [CI] 0.58 to 1.06). Among patients with definite or probable ischaemic stroke, glycerol was associated with a significant reduction in the odds of death (OR 0.65, 95% CI 0.44 to 0.97). However, at the end of the scheduled follow up period, there was no significant difference (OR 0.98, 95% CI 0.73 to 1.31). Functional outcome was reported in only two studies but there were non-significantly more patients who had a good outcome at the end of scheduled follow up (OR 0.73, 95% CI 0.37 to 1.42). Haemolysis seems to be the only relevant adverse effect of glycerol treatment.
Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals) and by indirectness (differences in studied patients: a mix of haemorrhagic, ischaemic and lacunar stroke).