The immediate and long-term effects of mannitol and glycerol. A comparative experimental study.
A prolonged experimental situation of focal vasogenic oedema, producing mild intracranial hypertension, was developed. The aim was to study the immediate and long-term effects of repeated infusions of mannitol and glycerol on intracranial pressure (ICP) and cerebral blood flow (CBF). Eighteen goats were operated on twice to implant: an epidural latex balloon in each cerebral hemisphere to measure ICP; an electromagnetic flowmeter around both internal maxillary arteries (the only cerebral blood input), after tying the extracranial branches, to measure the CBF; and two femoral catheters to measure blood pressure (BP) and for intravenous infusion (IV). Three groups of 6 goats each were formed: A) control; the BP and bilateral ICPs and CBFs were recorded under basal conditions and every 4 hours for 3 days after a cold injury (CI) was provoked; B) 20% mannitol solution 1 g/kg body weight injected every 12 hr starting at 24 hr post-CI; and C) 10.1% glycerol solution 0.5 g/kg body weight, administered as mannitol. Glycerol, as compared to mannitol, presents the following major differences among its immediate post infusion effects: a lesser decrease in ICP, but no rebound phenomenon; lesser elevation of BP; CBF increases more gradually and constantly. Long-term effects with mannitol consisted of a rebound phenomenon observed in ICP during the last 12 hr. In all 3 groups, it was observed that CBF increases in relation to the ICP level.
García-Sola
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R
Department of Neurosurgery, Hospital de la Princesa, Madrid, Spain.
Pulido
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Capilla
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D000818:Animals; D001929:Brain Edema / Q000150:complications / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D005990:Glycerol / Q000494:pharmacology*; D006041:Goats; D007427:Intracranial Pressure / Q000187:drug effects*; D008353:Mannitol / Q000494:pharmacology*; D011559:Pseudotumor Cerebri / Q000209:etiology / Q000503:physiopathology; D014664:Vasodilation / Q000187:drug effects
D008353:Mannitol; D005990:Glycerol