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mannitol AND hypertonic saline

H C Ferreira-Neto, I M R Ribeiro, T S Moreira, S T Yao, V R Antunes
Increases in plasma osmolality activates the paraventricular nucleus of the hypothalamus (PVN) which in turn mounts a physiological response by increasing the release of arginine vasopressin and sympathetic nerve activity to end organs such as the kidney. The PVN expresses an abundance of purinergic receptors including P2X2 receptors. In the present study, we sought to determine 1) whether P2X2-expressing PVN neurons are activated by hypertonic saline or hypertonic mannitol and 2) what effects P2X receptor blockade has on sympathetic nerve activation mediated by a hyperosmotic stimulus...
March 6, 2017: Neuroscience
Jingxue Fang, Yanzhang Yang, Wei Wang, Yang Liu, Tong An, Meijuan Zou, Gang Cheng
There is a controversy about the effects of hypertonic saline (HS) used for brain relaxation in patients requiring craniotomies. We conducted a meta-analysis to compare the efficacy of equiosmolar hypertonic saline with mannitol on intraoperative brain relaxation in patients undergoing craniotomies. We searched PubMed, EMBASE, Cochrane Library databases, and Web of Science for randomized controlled trials (RCTs). The outcome indicators included brain relaxation, hemodynamic status, fluid volume, and blood chemistry...
March 3, 2017: Neurosurgical Review
M Czosnyka, J D Pickard, L A Steiner
Intracranial pressure (ICP) is governed by volumes of intracranial blood, cerebrospinal fluid, and brain tissue. Expansion of any of these volumes will trigger compensatory changes in the other compartments, resulting in initially limited change in ICP. Due to the rigid skull, once compensatory mechanisms are exhausted, ICP rises very rapidly. Intracranial hypertension is associated with unfavorable outcome in brain-injured patients. This chapter discusses the pathophysiology of raised ICP, as well as typical waveforms, monitoring techniques, and clinical management...
2017: Handbook of Clinical Neurology
Aniruddha Tekkatte Jagannatha, Sriganesh Kamath, Indira Devi, Umamaheswara G S Rao
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
Leonardo M Sousa, Almir F de Andrade, Alessandro R Belon, Matheus S Soares, Robson Luis Amorim, Jose Pinhata Otochi, Manoel J Teixeira, Wellingson S Paiva
BACKGROUND Current clinical treatment methods for refractory intracranial hypertension include elevation of the decubitus, ventilation adjustment, and use of hypertonic solutions such as hypertonic saline and mannitol solutions. Previous studies have shown that hypertonic solutions are particularly effective. Although several concentrations of saline solution have been proposed, a 3% solution is the most widely used. The aim of this study was to evaluate the maintained efficacy of a 3% hypertonic saline solution in an experimental model of intracranial hypertension...
October 25, 2016: Medical Science Monitor Basic Research
Nadia Roumeliotis, Christian Dong, Géraldine Pettersen, Louis Crevier, Guillaume Emeriaud
OBJECTIVES: The objectives of the study are to describe the use of hyperosmolar therapy in pediatric traumatic brain injury (TBI) and examine its effect on intracranial pressure (ICP) and cerebral perfusion pressure (CPP). DESIGN: A retrospective review of patients with severe TBI admitted to the pediatric intensive care unit (PICU) was conducted. Inclusion criteria were ICP monitoring and administration of a hyperosmolar agent (20 % mannitol or 3 % hypertonic saline) within 48 h of PICU admission; for which dose and timing were recorded...
December 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Clizia Cazzarolli, Chiara Tartali, Ugo Pradal
No abstract text is available yet for this article.
August 26, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Aniruddha Tekkatte Jagannatha, Sriganesh Kamath, Indira Devi, Umamaheswara G S Rao
INTRODUCTION: Osmotherapy forms an integral part in the management of patients with severe traumatic brain injury (TBI). An ideal choice between mannitol and hypertonic saline (HTS) remains to be conclusively proven. More importantly, attention has not been paid to the long-term osmolarity changes during the therapy. The current prospective randomized study aims at evaluating the effect of serum and urine osmolarity and sodium achieved with mannitol and HTS on intracranial pressure (ICP) and outcome...
August 2016: Neurosurgery
Eva Millqvist
Temperatures above and below what is generally regarded as "comfortable" for the human being have long been known to induce various airway symptoms, especially in combination with exercise in cold climate with temperatures below 0°C, which is naturally since exercise is followed by enhanced ventilation and thus greater amounts of inhaled cold air. The aim was to highlight the knowledge we have today on symptoms from the airways (here also including the eyes) arisen from various temperatures; the mechanisms, the pathophysiology and their clinical significance...
April 2015: Temperature: Multidisciplinary Biomedical Journal
Çağatay Çalıkoğlu, Mehmet Hüseyin Akgül, Osman Akgül, Ayşe Karataş
BACKGROUND: Cerebral ischemia is a cause of serious morbidity and mortality. Strategies that would protect cerebral tissue against ischemic injury are important. The present study aimed to evaluate effects of surgical and medical treatments, either alone or in combination, on infarction area in an experimental rat model of cerebral ischemia. METHODS: Adult male Sprague-Dawley rats (n=30) were divided into 6 groups, each including 5 experimental animals. Cerebral ischemia was created by right common carotid artery occlusion (CCAO) under anesthesia...
December 2015: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Connie Yang, Mark Chilvers, Mark Montgomery, Sarah J Nolan
BACKGROUND: Dornase alfa is currently used as a mucolytic to treat pulmonary disease (the major cause of morbidity and mortality) in cystic fibrosis. It reduces mucus viscosity in the lungs, promoting improved clearance of secretions. This is an update of a previously published review. OBJECTIVES: To determine whether the use of dornase alfa in cystic fibrosis is associated with improved mortality and morbidity compared to placebo or other medications that improve airway clearance, and to identify any adverse events associated with its use...
April 4, 2016: Cochrane Database of Systematic Reviews
Sudheer Ambekar, Venkatesh Madhugiri, Paritosh Pandey, Dileep R Yavagal
BACKGROUND: The management of intracranial aneurysms (IAs) varies widely depending upon a number of factors. OBJECTIVE: To understand the variations in practice patterns in the treatment of IAs in India. METHODS: The survey consisted of 23 questions. Two group emails were sent to members of the Neurological Society of India and the Neurological Surgeons Society of India. Uni- and multivariate analysis was performed where appropriate. RESULTS: The response rate was 10...
March 2016: Neurology India
Y Y Deng, F C Shen, D Xie, Q P Han, M Fang, C B Chen, H K Zeng
Cerebral edema causes intracranial hypertension (ICH) which leads to severe outcome of patients in the clinical setting. Effective anti-edema therapy may significantly decrease the mortality in a variety of neurological conditions. At present drug treatment is a cornerstone in the management of cerebral edema. Osmotherapy has been the mainstay of pharmacologic therapy. Mannitol and hypertonic saline (HS) are the most commonly used osmotic agents. The relative safety and efficacy of HS and mannitol in the treatment of cerebral edema and reduction of enhanced ICP have been demonstrated in the past decades...
2016: Mini Reviews in Medicinal Chemistry
Aniruddha Tekkatte Jagannatha, Kamath Sriganesh, Bhagavatula Indira Devi, Ganne Sesha Umamaheswara Rao
The impact of hypertonic saline (HTS) on long term control of intracranial hypertension (ICH) is yet to be established. The current prospective randomized controlled study was carried out in 38 patients with severe traumatic brain injury (TBI). Over 450 episodes of refractory ICH were treated with equiosmolar boluses of 20% mannitol in 20 patients and 3.0% HTS in 18 subjects. Intracranial pressure (ICP) was monitored for 6days. ICP and cerebral perfusion pressure (CPP) were comparable between the groups. The mannitol group had a progressive increase in the ICP over the study period (p=0...
May 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Sandra D Anderson
Indirect challenges act to provoke bronchoconstriction by causing the release of endogenous mediators and are used to identify airway hyper-responsiveness. This paper reviews the historical development of challenges, with exercise, eucapnic voluntary hyperpnoea (EVH) of dry air, wet hypertonic saline, and with dry powder mannitol, that preceded their use in clinical practice. The first challenge developed for clinical use was exercise. Physicians were keen for a standardized test to identify exercise-induced asthma (EIA) and to assess the effect of drugs such as disodium cromoglycate...
2016: European Clinical Respiratory Journal
Audrey Leasure, W Taylor Kimberly, Lauren H Sansing, Kristopher T Kahle, Golo Kronenberg, Hagen Kunte, J Marc Simard, Kevin N Sheth
Cerebral edema (i.e., "brain swelling") is a common complication following intracerebral hemorrhage (ICH) and is associated with worse clinical outcomes. Perihematomal edema (PHE) accumulates during the first 72 h after hemorrhage, and during this period, patients are at risk of clinical deterioration due to the resulting tissue shifts and brain herniation. First-line medical therapies for patients symptomatic of PHE include osmotic agents, such as mannitol in low- or high-dose bolus form, or boluses of hypertonic saline (HTS) at varied concentrations with or without subsequent continuous infusion...
February 2016: Current Treatment Options in Neurology
Sarah Burgess, Riyad B Abu-Laban, Richard S Slavik, Erik N Vu, Peter J Zed
OBJECTIVE: To comparatively evaluate hypertonic sodium (HTS) and mannitol in patients following acute traumatic brain injury (TBI) on the outcomes of all-cause mortality, neurological disability, intracranial pressure (ICP) change from baseline, ICP treatment failure, and serious adverse events. DATA SOURCES: PubMed, EMBASE, CENTRAL, Cochrane Database of Systematic Reviews,, and WHO ICTRP (World Health Organization International Clinical Trials Registry Platform) were searched (inception to November 2015) using hypertonic saline solutions, sodium chloride, mannitol, osmotic diuretic, traumatic brain injury, brain injuries, and head injury...
April 2016: Annals of Pharmacotherapy
Steven L Shein, Nikki M Ferguson, Patrick M Kochanek, Hülya Bayir, Robert S B Clark, Ericka L Fink, Elizabeth C Tyler-Kabara, Stephen R Wisniewski, Ye Tian, G K Balasubramani, Michael J Bell
OBJECTIVES: To describe acute cerebral hemodynamic effects of medications commonly used to treat intracranial hypertension in children with traumatic brain injury. Currently, data supporting the efficacy of these medications are insufficient. DESIGN: In this prospective observational study, intracranial hypertension (intracranial pressure ≥ 20 mm Hg for > 5 min) was treated by clinical protocol. Administration times of medications for intracranial hypertension (fentanyl, 3% hypertonic saline, mannitol, and pentobarbital) were prospectively recorded and synchronized with an automated database that collected intracranial pressure and cerebral perfusion pressure every 5 seconds...
March 2016: Pediatric Critical Care Medicine
Myles Dustin Boone, Achikam Oren-Grinberg, Timothy Matthew Robinson, Clark C Chen, Ekkehard M Kasper
BACKGROUND: Intracranial hypertension, defined as an intracranial pressure (ICP) >20 mmHg for a period of more than 5 min, worsens neurologic outcome in traumatic brain injury (TBI). While several mechanisms contribute to poor outcome, impaired cerebral perfusion appears to be a highly significant common denominator. Management guidelines from the Brain Trauma Foundation recommend measuring ICP to guide therapy. In particular, hyperosmolar therapy, which includes mannitol or hypertonic saline (HTS), is frequently administered to reduce ICP...
2015: Surgical Neurology International
Joaquín Hernández-Palazón, Diego Fuentes-García, Paloma Doménech-Asensi, Claudio Piqueras-Pérez, Luis Falcón-Araña, Sebastián Burguillos-López
BACKGROUND: The authors investigated the effect of equiosmolar, equivolemic solutions of 3% hypertonic saline (HS) and 20% mannitol on blood coagulation assessed by rotational thromboelastometry (ROTEM) and standard coagulation tests during elective craniotomy. METHODS: In a prospective, randomized, double-blind trial, 40 patients undergoing elective craniotomy were randomized to receive 5 mL/kg of either 20% mannitol or 3% HS for intraoperative brain relaxation...
January 2017: Journal of Neurosurgical Anesthesiology
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