Hemodynamic effects of mannitol infusion in patients with acute intracerebral hemorrhage

Abstract

. Design of the study, critical revision. ABSTRACT PURPOSE:To evaluate hemodynamic effects of mannitol infusion in patients with acute intracerebral hemorrhage. METHODS:Thirty patients with acute intracerebral hemorrhage were enrolled. Transcranial doppler was used to detect variables of bilateral middle cerebral arteria (MCA) including mean velocity (Vm) and pulsitility index (PI) before and after125ml and 250ml mannitol infusion (0, 30, 60, 90, 120, 180, 240 min). RESULTS:When 125ml or 250ml mannitol was infused in patients with acute intracerebral hemorrhage, Vm of bilateral MCA elevated, and reached the top at 30min, and then decreased. PI decreased in the affected MCA (250ml) and in the unaffected MCA (125ml and 250ml). CONCLUSION:Mannitol infusion in patients with acute intracerebral hemorrhage can improve cerebral blood flow in bilateral hemispheres and decrease intracranial pressure in the hemorrhagic hemisphere (250ml) and in the nonhemorrhagic hemisphere (125ml and 250ml).

Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations

“…Several observational studies investigated the effects of hyperosmolar fluids (MAN or HTS) in patients in whom monitoring consisted of trans-cranial Doppler [41,59,70], positron emission tomography [36,55], Xenon-CT [59,71,72], CT scan (to measure brain volume and shift, water content) [44,[73][74][75][76] or EEG [77]. GRADE: very low-quality evidence.…”

Effects of Mannitol 20% on Outcomes in Nontraumatic Intracerebral Hemorrhage

“…Studies on humans and animals suggest that prescribing common drugs may worsen prognosis,[78] and still some of patients may need to craniotomy. [9] Although craniotomy is used in treatment of intracranial hemorrhage, many patients, particularly old patients, cannot tolerate anesthesia or such procedures,[1011] but theoretically, the existence of hyperosmolar solutions such as mannitol 20% in cerebral arteries can effect the perilesional edema. [1213] Hence, beside therapeutic effect of conservative treatment the large number of such patients in our community, we decided to do a study method to evaluate the effects of mannitol 20% on outcome of patients with ICH in patients admitted to Isfahan's Al-Zahra Hospital.…”

Evaluation of Role of Mannitol in the Assessment of Change of Intracranial Haematoma Volume by Neuroimaging Ct in Acute Intracerebral Haemorrhage

“…They found mannitol infusion in patients can improve cerebral blood flow in bilateral hemispheres and decrease intracranial pressure. 9 But, this is against the observation by Mishra et al where they said low-dose mannitol does not seem to be beneficial to patients with acute ICH. 10 Though, we have not used SPECT to measure cerebral blood flow, our observation again does not support the view of Kalita et al where they said that mannitol does not seem to change the regional cerebral blood flow in ICH by SPECT study.…”