title: Treatment of resistant intracranial hypertension with hypertonic saline. Report of two cases.
abstract: The authors describe two patients with traumatic cerebral edema and intracranial hypertension in whom the continued use of mannitol and furosemide resulted in a progressive lessening of the effect of these agents on the intracranial pressure (ICP) and caused prerenal failure. Intravenous administration of hypertonic saline (50 ml and 20 ml of a 5-mmol/ml saline solution over 10 minutes in Cases 1 and 2, respectively) produced a prolonged reduction in the ICP and improved renal function in both cases. It is suggested that if a reduction in ICP without diuresis is required in patients with traumatic cerebral edema, treatment with intravenous hypertonic saline should be considered.
authors.affiliation: Department of Anaesthesia and Intensive Care, Royal Adelaide Hospital, South Australia.
authors.forename: L I
authors.initials: LI
authors.lastname: Worthley
authors.forename: D J
authors.initials: DJ
authors.lastname: Cooper
authors.forename: N
authors.initials: N
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D001929:Brain Edema / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology; D006801:Humans; D007262:Infusions, Intravenous; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012965:Sodium Chloride / Q000627:therapeutic use*
chemical_list: D012462:Saline Solution, Hypertonic; D012965:Sodium Chloride