Hyperosmolar Therapy for the Intracranial Hypertension in Neurosurgical Practice: Mannitol Versus Hypertonic Saline - Pages 56-61

Jiao Li and Baoguo Wang

Department of Anesthesiology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China

DOI: http://dx.doi.org/10.14205/2310-9394.2013.01.01.7

Abstract:

Management of cerebral edema and elevated intracranial pressure (ICP) is a critical determinant of patient outcomes. Osmotherapy is the most important options in the medical treatments including controlled ventilation, osmotherapy, maintenance of brain and body homeostasis and sedation. Mannitol and hypertonic saline (HTS) are frequently used among osmotic agents related to brain edema and high ICP. Although mannitol is recommended in guidelines, hypertonic saline seems advantageous over mannitol in many situations, such as providing sustained hemodynamic stability and immunologic effects and less rebound phenomenon. Thus, HTS is emerging as a secure alternative to mannitol in the treatment of intracranial hypertension.

Keywords: Hyperosmolar therapy, Mannitol, Hypertonic saline, Intracranial pressure, Neurosurgery.