title: Low blood-to-cerebrospinal fluid passage of sorbitol after intravenous infusion.
abstract: OBJECTIVE
  Compared with mannitol, the osmotherapeutic agent sorbitol is less prone to accumulate in the blood and the same quantity may be infused in a smaller volume. Because of these advantageous characteristics, we studied the pharmacokinetics of sorbitol in serum and cerebrospinal fluid.
  
  
  METHODS
  Six patients (five women and one man; age range, 46-70 years) with an external ventriculostomy and suffering from brain edema due to cerebrovascular disease received sorbitol as part of their therapy. Before and after the first dose of 50 g infused over 20 minutes, sorbitol concentrations in serum and cerebrospinal fluid were determined repeatedly using an enzymatic procedure.
  
  
  RESULTS
  Maximal sorbitol concentrations ranged from 2,705 to 5,821 (median, 3,227) mg/l in serum compared with 6.7-130.7 (median, 19.5) mg/l in cerebrospinal fluid. Cerebrospinal fluid maxima were observed 0.17-3 hours after the end of the infusion. Sorbitol elimination in serum was adequately described by a two-compartment pharmacokinetic model (distribution half-life, 0.05-0.14 hour; elimination half-life, 0.23-0.61 hour). Elimination in cerebrospinal fluid followed a single-exponential decay and was considerably slower than that in serum (half-life, 1.3-7.7 hours).
  
  
  CONCLUSIONS
  The maximal cerebrospinal fluid concentration/maximal serum concentration ratio was low for sorbitol, thus suggesting a small potential risk of inducing an increase of intracranial pressure after osmotherapy (rebound effect).
authors.affiliation: Department of Neurology, University of Göttingen, FRG.
authors.forename: R
authors.initials: R
authors.lastname: Nau
authors.forename: T
authors.initials: T
authors.lastname: Dreyhaupt
authors.forename: H
authors.initials: H
authors.lastname: Kolenda
authors.forename: H W
authors.initials: HW
authors.lastname: Prange
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000097:blood; D002544:Cerebral Infarction / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D013012:Sorbitol / Q000008:administration & dosage / Q000097:blood* / Q000134:cerebrospinal fluid; D013997:Time Factors
chemical_list: D013012:Sorbitol