The effects of rapid infusions of saline and mannitol on cerebral blood volume and intracranial pressure in dogs

Ravussin, P.; Archer, David P.; Meyer, E.; Abou-Madi, M.; Yamamoto, Lucas Y.; Trop, D.

doi:10.1007/bf03010801

Cited by 32 publications

(13 citation statements)

References 27 publications

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“…Mannitol is widely used in veterinary medicine as an osmotic diuretic as well as to increase serum osmolality in the management of brain edema . In our study, maximal mannitol concentration documented after bolus administration was approximately 300 mg/dL, and the concentration decreased rapidly, most likely because of redistribution in the extracellular fluid and elimination.…”

Section: Discussionmentioning

confidence: 99%

Sequential changes in urine production, glomerular filtration rate, and electrolyte excretion after mannitol administration

Segev

Stafford

Kirby

et al. 2019

Veterinary Internal Medicne

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Introduction Acute kidney injury (AKI) leading to severe uremia is associated with high morbidity and mortality. Mannitol is an osmotic diuretic, widely used in the management of AKI, both as a bolus injection and as a constant rate infusion (CRI). Objectives To determine the plasma concentration of mannitol after a bolus injection and CRI at the recommended dosages, and to assess the effect of mannitol on renal function variables including urine production, glomerular filtration rate (GFR), and solute excretion. Methods Prospective cross‐over design study, using 6 healthy dogs. Each dog underwent 3 protocols with at least a 7‐day washout period between protocols. The first protocol included bolus injection of mannitol, the second protocol included bolus injection followed by CRI of mannitol and the third protocol (control) included injection of 5% dextrose in water (D5W). Urine production, GFR, and fractional excretion (FE) of solutes were measured for 10 hours. Results For all protocols, urine production significantly ( P < .001) increased after bolus injection, but no significant difference in urine production or GFR was observed among the treatment groups. Mannitol injection increased the FE of sodium and urea nitrogen, but these effects were short ‐ lived. Conclusions Mannitol has minimal effect on urine production and GFR but does increase FE of urea nitrogen and sodium, immediately after bolus injection. Constant rate infusion at a conventional dosage of 1 mg/kg/min cannot maintain these effects in dogs with normal renal function, because mannitol concentration decreases rapidly.

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Section: Discussionmentioning

confidence: 99%

Sequential changes in urine production, glomerular filtration rate, and electrolyte excretion after mannitol administration

Segev

Stafford

Kirby

et al. 2019

Veterinary Internal Medicne

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“…In a cat model of brain edema, CBV (measured by laser Doppler flowmetry) increased following mannitol 23 . Studies in dogs using labeled red blood cells found an early 20–25% increase in CBV 1–3 minutes after mannitol bolus 24 .…”

Section: Discussionmentioning

confidence: 99%

Effect of Mannitol on Cerebral Blood Volume in Patients With Head Injury

et al. 2012

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Background Mannitol has traditionally been the mainstay of medical therapy for intracranial hypertension in patients with head injury. We previously demonstrated that mannitol reduces brain volume in patients with cerebral edema, although whether this occurs due to a reduction in brain water, blood volume or both remains poorly understood. Objective To test the hypothesis that mannitol acts by lowering blood viscosity leading to reflex vasoconstriction and a fall in cerebral blood volume (CBV). Methods We used 15O PET to study six patients with traumatic brain injuries requiring treatment for intracranial hypertension. Cerebral blood flow (CBF), CBV and cerebral metabolic rate for oxygen (CMRO2) were measured before and one hour after administration of 1.0 g/kg 20% mannitol. Results CBV rose from 4.1 ± 0.4 to 4.2 ± 0.2 ml/100g (p=0.3) while ICP fell from 21.5 ± 4.9 to 13.7 ± 5.1 mm Hg (p< 0.003) after mannitol. Blood pressure, PaCO2, oxygen content, CBF and CMRO2 did not change. Conclusion A single bolus of 1 g/Kg of 20% mannitol does not acutely lower CBV. Another mechanism, such as a reduction in brain water, may better explain mannitol’s ability to lower ICP and reduce mass effect.

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“…The reason for this interest began quite innocently: so very little was known about the fundamental pharmacology and physiology as related to the central nervous system that virtually any new information was welcomed. It was not until the mid-1980s when Patrick Ravussin and David Archer in Montreal, 102,103 and a decade later when Rosemary Craen, T.Y. 18,19,54,55 Most of the early research was targeted to topics of longstanding interest or was hypothesis-driven; however, as the methodologies used for measurement became more widely available, "investigations of opportunity" began to proliferate.…”

Section: Studies Of Cerebral Physiology and Pharmacologymentioning

confidence: 99%

The History of Neuroanesthesiology

Lanier¹

2012

Journal of Neurosurgical Anesthesiology

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Neuroanesthesiology has a rich history. Although advances in research and clinical practice were cornerstones for the development of this field, other equally critical factors came into play. These include the development of subspecialty societies, formal dissemination of information through textbooks and journal publications, and, most importantly, strong leadership. This article reviews important advances within the subspecialty and many individuals behind those advances. The analysis and speculative synthesis provide insights into the current status of neuroanesthesiology and possible directions for the subspecialty's future.

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The effects of rapid infusions of saline and mannitol on cerebral blood volume and intracranial pressure in dogs

Cited by 32 publications

References 27 publications

Sequential changes in urine production, glomerular filtration rate, and electrolyte excretion after mannitol administration

Sequential changes in urine production, glomerular filtration rate, and electrolyte excretion after mannitol administration

Effect of Mannitol on Cerebral Blood Volume in Patients With Head Injury

The History of Neuroanesthesiology

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