Evaluation of mannitol as an osmotherapeutic agent in traumatic brain injuries by measuring serum osmolality

Sharma, RM; Setlur, Rangraj; Swamy, MN

doi:10.1016/s0377-1237(11)60047-6

Cited by 7 publications

(6 citation statements)

References 16 publications

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“…For this physiological reason, the mechanism of action of osmotic diuretics (mannitol) is to increase plasma osmolality and draw normal fluid from low osmolar brain cells to high osmolar intravascular fluid, to reduce brain oedema. [18][19][20] The renal system works to limit water reabsorption, especially in the segments where the nephron is highly permeable to water, namely the proximal tubule and the descending loop of Henle. The presence of substances that cannot be reabsorbed by normal water by entering an osmotic pressure that opposes the balance.…”

Section: Increased Intracranial Pressurementioning

confidence: 99%

Regulation and Intervention of Intracranial Pressure

Suasti¹

2021

Bioscmed

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Intracranial pressure is the total amount of pressure exerted by the brain, blood and cerebrocinal fluid in the rigid cranial space. Compliance is an indicator of the brain's tolerance for increased ICP, when compliance is exceeded, there will be a dramatic increase in the pressure/volume curve so that ICP will increase rapidly. In the injured brain, cerebral blood flow (CBF) is regulated to supply sufficient oxygen and substrates to the brain. Certain physiological factors such as hypercarbia, acidosis and hypoxemia cause vasodilation which causes an increase in CBF, seizure activity and fever will increase the level of brain metabolism and CBF. Cerebral edema is the most common cause of non-traumatic brain injury such as central nervous system infections, metabolic and systemic encephalopathy. Vasogenic brain edema occurs due to injury to the blood-brain barrier and increased capillary permeability in the area around the injury, or to inflammation, especially in CNS infections. Medical management of elevated intracranial pressure includes sedation, cerebrospinal fluid drainage, and osmotherapy with either mannitol or hypertonic salts.

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Section: Increased Intracranial Pressurementioning

confidence: 99%

Regulation and Intervention of Intracranial Pressure

Suasti¹

2021

Bioscmed

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“…6 bahwa manitol akan menaikkan osmolaritas lebih tinggi dibanding dengan natrium laktat hipertonik, akan tetapi tidak sesuai dengan penelitian Sharma dkk. 7 bahwa pemberian manitol akan menaikkan osmolaritas plasma di atas 320 mOsm/kg.…”

Section: Tabel 4 Perbedaan Volume Urin Dan Osmolaritas Darah Antara Kunclassified

Perbandingan Osmolaritas Plasma Setelah Pemberian Manitol 20% 3 mL/kgBB dengan Natrium Laktat Hipertonik 3 mL/kgBB pada Pasien Cedera Otak Traumatik Ringan-Sedang

Batubara¹,

Umar²,

Mursin³

2016

jap

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Terapi osmotik adalah salah satu cara penanganan pada cedera kepala traumatik untuk menurunkan tekanan intrakranial (TIK) dengan cara mengatasi edema yang terjadi. Penelitian ini dilakukan pada 30 pasien cedera otak traumatik ringan-sedang yang masuk ke UGD Rumah Sakit H. Adam Malik Medan pada Oktober-Desember 2015 yang memenuhi kriteria inklusi dan tidak termasuk eksklusi. Subjek dibagi menjadi 2 kelompok secara acak, yaitu kelompok A diberikan manitol 20% 3 mL/kgBB dan kelompok B diberikan natrium laktat hipertonik 3 mL/kgBB. Dilakukan penilaian osmolaritas sebelum perlakuan dan 60 menit setelah perlakuan dengan cara pengambilan darah, kemudian dilakukan pemeriksaan laboratorium. Data hasil penelitian diuji dengan uji T-independent dan Uji Mann-Whitney. Dari hasil penelitian didapatkan efek perubahan osmolaritas plasma setelah perlakuan tidak bermakna secara statistik (p>0,05) walaupun osmolaritas plasma akhir setelah perlakuan pada kedua kelompok berbeda bermakna (p<0,05). Volume urin lebih banyak pada kelompok manitol dan bermakna secara statistik (p<0,05), akan tetapi tidak ada perubahan hemodinamik yang bermakna. Dari hasil penelitian disimpulkan bahwa manitol lebih baik dalam hal target osmolaritas plasma pada pasien cedera otak traumatik ringan sedang.

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“…This figure was obtained from the results of experimental tests of blood viscosity with oxygen carrying capacity. [15][16][17][18][19][20] This study was the first research in assessing the benefits of hematocrit levels as a marker for administration of mannitol in cases of severe head injury in the Malay population in South Sumatra, Indonesia.…”

Section: Introductionmentioning

confidence: 99%

Hematocrit Changes as Parameters for Giving Mannitol in Severe Head Injury

Susanto¹,

Permono²

2018

sjs

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ABSTRACT Introduction. Incidence of head injuries is also quite high in Indonesia, around 1.4 million cases per year with a mortality rate of 15-20% in the population aged 5 to 35 years. Head injuries are commonly divided into two separate time periods namely primary and secondary brain injuries. Primary brain injury is physical damage to the parenchyma (tissue and blood vessels) that occurs during a traumatic event, thus causing compression of the surrounding brain tissue. Secondary brain injury is a continuation of the results of primary brain injury with the main complications of brain injury in the following hours and days. This study was aimed to asses the benefits of administration of mannitol in cases of severe head injury in South Sumatra, Indonesia. Methods. This research was a clinical trial without comparison by looking at hematocrit levels in patients with severe head injuries with intracranial hypertension before and after given mannitol therapy. Data analysis was performed with IBM SPSS Version 23. Data was presented in the form of narrative tables. Then the paired T test was performed. P value <0.05. Results. From 39 research subjects, the age of the subjects ranged between 6-88 years with an average of 33 years. Based on sex there were 28 male sufferers (71.8%) and there were 11 female sufferers 28.2%. GCS varies from 3 to GCS 8 intra-cranial abnormalities. From 39 research subjects with severe head injury without surgery, a hematocrit examination was performed before, after 10 minutes and 6 hours of injection of mannitol bolus 1 g / kg body weight. It was obtained that averaged hematocrit before mannitol administration was 34, after 10 minutes was 33 and after 6 hours was 35. Conclusion. There is a decrease in hematocrit levels after administration of bolus mannitol 1 g / kg BW at the beginning of mannitol administration and hematocrit will increase again after 6 hours of mannitol administration

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Evaluation of mannitol as an osmotherapeutic agent in traumatic brain injuries by measuring serum osmolality

Cited by 7 publications

References 16 publications

Regulation and Intervention of Intracranial Pressure

Regulation and Intervention of Intracranial Pressure

Perbandingan Osmolaritas Plasma Setelah Pemberian Manitol 20% 3 mL/kgBB dengan Natrium Laktat Hipertonik 3 mL/kgBB pada Pasien Cedera Otak Traumatik Ringan-Sedang

Hematocrit Changes as Parameters for Giving Mannitol in Severe Head Injury

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