The Influence of High and Low Dosages of Mannitol 25% in the Therapy of Cerebral Edema

Kühner, Anja; Roquefeuil, B; Viguie, E; Frèrebeau, P; Peraz-Dominguez, E.; Bazin, M.; Privat, Jean-Marie; Gros, Cécile

doi:10.1007/978-3-642-65734-4_13

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…Severe dehydration can also be avoided in most patients when a low-dose regimen is used. Our results, therefore, confirm in a more controlled fashion the report of Kfihner,et .al.,1 who also found that much smaller doses than those previously recommended a,5 are effective in the treatment of intracranial hypertension.…”

Section: Discussionmentioning

confidence: 90%

Mannitol dose requirements in brain-injured patients

Marshall¹,

Smith²,

Rauscher³

et al. 1978

Journal of Neurosurgery

229

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There is little information as to the optimal use of mannitol. To determine the dose-response relationship, the osmotic gradient required, and the time course of intracranial pressure (ICP) reduction produced by mannitol, eight patients with acute head injury were studied in whom ICP was monitored with a ventriculostomy and found to be elevated. Ventilation was controlled to a pCO2 of 25 +/- 3 mm Hg and all were paralyzed with Pavulon. None had received barbiturates. Before mannitol administration the intracranial volume-pressure response was determined. Mannitol was administered as a bolus of 0.25 gm/kg, 0.5 gm/kg, and in six patients, 1 gm/kg, separated by at least 8 hours. In all patients the ICP reduction with 0.25 gm/kg (41.3 +/- 10.2 mm Hg leads to 16.4 +/- 5.6, p less than 0.01) was equivalent to that achieved with the larger doses. Serum osmolality rises of 10 mOsm or more were associated with a reduction in ICP. Much smaller doses than those previously recommended were effective in reducing the ICP acutely, although at 5 hours there was a trend toward persistent reduction when the larger dose is used. This trend was small and indicates that smaller and more frequent doses are as effective in reducing the ICP while avoiding the risk of osmotic disequilibrium and severe dehydration.

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Section: Discussionmentioning

confidence: 90%

Mannitol dose requirements in brain-injured patients

Marshall¹,

Smith²,

Rauscher³

et al. 1978

Journal of Neurosurgery

229

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show abstract

“…Based on earlier investigations sorbitol and mannitol solutions were given in doses of lg/kg/BW (2,14,17). Infusion time was 15 min.…”

Section: Dosagementioning

confidence: 99%

Monitoring of intracranial pressure in patients with severe head injury: A review of 100 cases

Goblet¹

1977

Minim Invasive Neurosurg

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“…In cases of traumatic cerebral edema most authors at present recommend as basic therapy hyperventilation and administration of saluretics or osmodiuretics (4). In considering the favorable experiences with dexamethasone in the treatment of perifocal edema in cases of brain tumors (5,6), the objective of our study was to prove the use of steroids in varying doses to prevent and treat post-traumatic cerebral edema.…”

Section: Introductionmentioning

confidence: 99%