» Articles » PMID: 16174920

Osmotic Therapy: Fact and Fiction

Overview
Journal Neurocrit Care
Specialty Critical Care
Date 2005 Sep 22
PMID 16174920
Citations 41
Authors
Affiliations
Soon will be listed here.
Abstract

This review examines the available data on the use of osmotic agents in patients with head injury and ischemic stroke, summarizes the physiological effects of osmotic agents, and presents the leading hypotheses regarding the mechanism by which they reduce ICP. Finally, it addresses the validity of the following commonly held beliefs: mannitol accumulates in injured brain; mannitol shrinks only normal brain and can increase midline shift; osmolality can be used to monitor mannitol administration; mannitol should be not be administered if osmolality is >320 mOsm; and hypertonic saline is equally effective as mannitol.

Citing Articles

Hemorrhagic stroke in children.

Askarova A, Zhurkabayeva B J Cent Nerv Syst Dis. 2024; 16:11795735241289913.

PMID: 39493255 PMC: 11531028. DOI: 10.1177/11795735241289913.


Development and verification of a nomogram for predicting short-term mortality in elderly ischemic stroke populations.

Jin G, Hu W, Zeng L, Diao M, Chen H, Chen J Sci Rep. 2023; 13(1):12580.

PMID: 37537270 PMC: 10400586. DOI: 10.1038/s41598-023-39781-4.


Intracranial Pressure Monitoring and Management in Aneurysmal Subarachnoid Hemorrhage.

Addis A, Baggiani M, Citerio G Neurocrit Care. 2023; 39(1):59-69.

PMID: 37280411 PMC: 10499755. DOI: 10.1007/s12028-023-01752-y.


Prediction of long-term mortality in patients with ischemic stroke based on clinical characteristics on the first day of ICU admission: An easy-to-use nomogram.

Jin G, Hu W, Zeng L, Ma B, Zhou M Front Neurol. 2023; 14:1148185.

PMID: 37122313 PMC: 10140521. DOI: 10.3389/fneur.2023.1148185.


Initial Diagnosis and Management of Acutely Elevated Intracranial Pressure.

Kareemi H, Pratte M, English S, Hendin A J Intensive Care Med. 2023; 38(7):643-650.

PMID: 36802976 PMC: 10302390. DOI: 10.1177/08850666231156589.


References
1.
Burke A, Quest D, Chien S, Cerri C . The effects of mannitol on blood viscosity. J Neurosurg. 1981; 55(4):550-3. DOI: 10.3171/jns.1981.55.4.0550. View

2.
Horn P, Munch E, Vajkoczy P, Herrmann P, Quintel M, Schilling L . Hypertonic saline solution for control of elevated intracranial pressure in patients with exhausted response to mannitol and barbiturates. Neurol Res. 1999; 21(8):758-64. DOI: 10.1080/01616412.1999.11741010. View

3.
Berger S, Schurer L, Hartl R, Messmer K, Baethmann A . Reduction of post-traumatic intracranial hypertension by hypertonic/hyperoncotic saline/dextran and hypertonic mannitol. Neurosurgery. 1995; 37(1):98-107; discussion 107-8. DOI: 10.1227/00006123-199507000-00015. View

4.
Silver F, Norris J, Lewis A, Hachinski V . Early mortality following stroke: a prospective review. Stroke. 1984; 15(3):492-6. DOI: 10.1161/01.str.15.3.492. View

5.
Bouma G, Muizelaar J, Bandoh K, Marmarou A . Blood pressure and intracranial pressure-volume dynamics in severe head injury: relationship with cerebral blood flow. J Neurosurg. 1992; 77(1):15-9. DOI: 10.3171/jns.1992.77.1.0015. View