Document Detail

Osmotherapy for Intracranial Hypertension: Mannitol Versus Hypertonic Saline.
MedLine Citation:
PMID:  22810253     Owner:  NLM     Status:  Publisher    
ABSTRACT: Purpose of Review: Hyperosmolar therapy is one of the core medical treatments for brain edema and intracranial hypertension, but controversy exists regarding the use of the most common agents, mannitol, and hypertonic saline. This article describes the relative merits and adverse effects of these agents using the best available clinical evidence.Recent Findings: Mannitol is effective and has been used for decades in the treatment of traumatic brain injury, but it may precipitate acute renal failure if serum osmolarity exceeds 320 mOsm/L. Hypertonic saline appears to be safe, and serum sodium has been elevated to as high as 180 mEq/L in clinical settings without significant neurologic, cardiac, or renal injury. In small comparative trials both agents are effective and no clinically significant difference has been noted, but a properly powered trial has not yet been performed.Summary: Both mannitol and hypertonic saline are effective and have an acceptable risk profile for use in the treatment of elevated intracranial pressure secondary to brain edema.
Matthew E Fink
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Publication Detail:
Journal Detail:
Title:  Continuum (Minneapolis, Minn.)     Volume:  18     ISSN:  1080-2371     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-7-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9509333     Medline TA:  Continuum (Minneapolis Minn)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  640-654     Citation Subset:  -    
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