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Murotov T M. Effect of Hyperosmolar Combined Solution of Mannitol
15% Plus 3.5% NaCl Solution on Cerebral Edema in
Patients With Traumatic Brain Injury. Iran J Neurosurg 2024; 10 : 23
URL: http://irjns.org/article-1-412-en.html
URL: http://irjns.org/article-1-412-en.html
Department of Anesthesiology and Resuscitation, Tashkent Medical Academy, Tashkent, Uzbekistan. , temurmalik_murotov@mail.ru
Abstract: (1523 Views)
Background and Aim: Craniocerebral trauma is one of the vital public health problems and causes elevated intracranial pressure (ICP) and low cerebral perfusion pressure.
Methods and Materials/Patients: In this work, 15% hyperosmolar solution colloid-mannitol and 3.5% crystalloid-sodium chloride (NaCl) were used simultaneously. Both have the same mechanism of action creating an osmotic gradient between the blood-brain barrier and brain tissue. In a single-center, randomized open clinical study, 35 patients were treated in the intensive care unit (ICU) with isolated traumatic brain injury aged 18 to 65 years with depression of consciousness (4-12 points on the Glasgow coma scale [GCS]), and abnormal computed tomography (CT) data of the head on admission.
Results: The data demonstrated the positive effect of mannitol 15% + NaCl 3.5% on ICP and cerebral blood flow. At 20-25 minutes after administration of a bolus of mannitol 15% + NaCl 3.5%, ICP decreased (stage 2) below 20 mm Hg, reaching an average of 18.1±0.72 mm Hg, which was a 33.2% decrease from baseline.
Conclusion: Combined use of mannitol 15% + NaCl 3.5% in the treatment of intracranial hypertension (ICH) in patients with isolated craniocerebral 3.5±0.2 mL/kg can be recommended in patients with baseline hypovolemia and hyponatremia.
Methods and Materials/Patients: In this work, 15% hyperosmolar solution colloid-mannitol and 3.5% crystalloid-sodium chloride (NaCl) were used simultaneously. Both have the same mechanism of action creating an osmotic gradient between the blood-brain barrier and brain tissue. In a single-center, randomized open clinical study, 35 patients were treated in the intensive care unit (ICU) with isolated traumatic brain injury aged 18 to 65 years with depression of consciousness (4-12 points on the Glasgow coma scale [GCS]), and abnormal computed tomography (CT) data of the head on admission.
Results: The data demonstrated the positive effect of mannitol 15% + NaCl 3.5% on ICP and cerebral blood flow. At 20-25 minutes after administration of a bolus of mannitol 15% + NaCl 3.5%, ICP decreased (stage 2) below 20 mm Hg, reaching an average of 18.1±0.72 mm Hg, which was a 33.2% decrease from baseline.
Conclusion: Combined use of mannitol 15% + NaCl 3.5% in the treatment of intracranial hypertension (ICH) in patients with isolated craniocerebral 3.5±0.2 mL/kg can be recommended in patients with baseline hypovolemia and hyponatremia.
Article number: 23
Keywords: Mannitol, Hypertonic
sodium chloride (NaCl), Intracranial pressure (ICP), Cerebral perfusion pressure, Hyperosmolar therapy, Craniocerebral trauma
Type of Study: Research |
Subject:
Neurotrauma
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This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-By-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
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