The Effect of Mannitol on Cerebral Blood Flow

Jafar, J J; Johns, Lydia; Mullan, Sean

doi:10.1097/00132586-198702000-00001

Cited by 11 publications

(11 citation statements)

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“…This finding is in agreement with the results of several clinical and animal studies in which the SABP remained unaffected or even decreased after mannitol, probably due to a reactive decrease in the peripheral resistance. 6,7,27,31,41 Similarly, in contrast to patients with hemorrhagic shock, HS-HES does not increase SABP in euvolemic patients. 22,42,43 Mechanisms of HS-HES are complex, because HS-HES consists of 2 components: sodium chloride, which is mainly responsible for the osmotic gradient, and HES, which is added to maintain the short-lived volume effect of hypertonic saline.…”

Section: Discussionmentioning

confidence: 92%

Effects of Hypertonic Saline Hydroxyethyl Starch Solution and Mannitol in Patients With Increased Intracranial Pressure After Stroke

Schwarz

Schwab

Bertram

et al. 1998

Stroke

232

137

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Background and Purpose-The purpose of this study was to prospectively evaluate a protocol with hypertonic saline hydroxyethyl starch (HS-HES) and mannitol in stroke patients with increased intracranial pressure (ICP). Methods-We studied 30 episodes of ICP crisis in 9 patients. ICP crisis was defined as (1) a rise of ICP of more than 25 mm Hg (nϭ22), or (2) pupillary abnormality (nϭ3), or (3) a combination of both (nϭ5). Baseline treatment was performed according to a standardized protocol. For initial treatment, the patients were randomly assigned to either infusion of 100 mL HS-HES or 40 g mannitol over 15 minutes. For repeated treatments the 2 substances were alternated. ICP, blood pressure, and cerebral perfusion pressure (CPP) were monitored over 4 hours. Blood gases, hematocrit, blood osmolarity, and sodium were measured before and 15 and 60 minutes after the start of infusion. Treatment was regarded as effective if ICP decreased Ͼ10% below baseline value or if the pupillary reaction had normalized. Results-Treatment

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Section: Discussionmentioning

confidence: 92%

Effects of Hypertonic Saline Hydroxyethyl Starch Solution and Mannitol in Patients With Increased Intracranial Pressure After Stroke

Schwarz

Schwab

Bertram

et al. 1998

Stroke

232

137

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“…One of the nonosmotic mannitol effects is the protection against free radical-mediated ischemic cell damage (14 -16). Moreover, mannitol protects the brain by reducing blood viscosity (12,17,18).…”

Section: Introductionmentioning

confidence: 99%

Effects of Mannitol on Ischemia-Induced Degeneration in Rat Hippocampus

et al. 2004

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Abstract. Although mannitol has been used as an osmotherapeutic drug on brain injury, the clinical efficiency of the drug are still controversial. In the present study, we examined the effects of mannitol on the edema in a hippocampal slice due to brief ischemia. To evaluate the effects, we employed an image analysis system that consists of an infrared-differential interference contrast (IR-DIC) microscope, an infrared CCD camera, and a computer with custom-made software. By this system, severity of the edema can be quantified as the coefficient of variation (CV) of digitalized slice images. The dose-dependent improvement on the deteriorated hippocampal slices could be obtained by administration of mannitol (10, 50, and 100 mM) after 10-min ischemia. However, field excitatory postsynaptic potentials (fEPSP) in CA1 stratum radiatum, which disappeared during 10-min ischemia, were never recovered by mannitol after more than 20-min treatment. fEPSP were blocked by the effective dose of mannitol for morphological recovery, but the effects found to be reversible. Although we failed to find positive rescuing effects of mannitol on the synaptic activities after ischemia, the protective effects of the drug on ischemic edema may rescue the secondary damages around the infarct area.

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“…Current common clinical uses include treat ment of cerebral edema [1], prophylaxis of acute renal failure [2] and reduction of intraocular pressure in pa tients with glaucoma [3]. Because mannitol is osmotically active and is largely excreted by the kidney, intra vascular accumulation can occur in the setting of renal insufficiently.…”

Section: Introductionmentioning

confidence: 99%