Osmotherapy in neurosurgery – hyperosmolar mannitol or hypertonic saline?
Authors:
Dostálová Vlasta; Dostál Pavel; Schreiberová Jitka; Černý Vladimír
Authors‘ workplace:
Klinika anesteziologie, resuscitace a intenzivní medicíny, Fakultní nemocnice Hradec Králové
Published in:
Anest. intenziv. Med., 21, 2010, č. 1, s. 18-22
Category:
Intensive Care Medicine - Review Article
Overview
Hyperosmolar solutions of mannitol and hypertonic saline (HS) have been both used to treat elevated intracranial pressure in critically ill patients and during neurosurgery interventions. The hyperosmolarity of mannitol and HS, combined with the impermeability of the blood – brain barrier to mannitol and sodium, provides favourable conditions for moving water from the brain to the intravascular compartment. However, a number of prospective clinical trials comparing the effects of mannitol and HS on intracranial pressure have suggested that HS is at least as effective as, if not better than, mannitol in the treatment of intracranial hypertension and perifocal oedema.
Keywords:
osmotherapy – mannitol – hypertonic solution – sodium chloride – osmotic reflexion cofficient – vasogennic oedema
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