Hypertonic saline (7.5%) versus mannitol: a comparison for treatment of acute head injuries.
Hypertonic saline (7.5% NaCl = HS) was compared with 20% mannitol (MAN), for the treatment of increased intracranial pressure (ICP), in a large animal model of head injury. Sheep were instrumented for hemodynamic and ICP monitoring and fluid administration. Elevated ICP (20-25 mm Hg) was produced by inflating an epidural balloon for 1 hour. Animals were then given a bolus of 250 mL of either HS (n = 7) or MAN (n = 7) and monitored for 2 hours. No significant differences in hemodynamic variables were noted between groups. The ICP decreased to the same degree in both groups during the 2 hours of observation (HS = 11 +/- 3.8 mm Hg; MAN = 8 +/- 2 mm Hg). Brain water contents were also similar (HS = 3.68 +/- 0.09 mL H2O/g dry wt; MAN = 3.83 +/- 0.08 mL H2O/g dry wt). The 7.5% NaCl was equally effective in treating elevated ICP caused by a space-occupying lesion when compared with 20% mannitol. Hypertonic saline has the additional benefit of rapid cardiovascular resuscitation of associated hemorrhagic shock with small-volume infusion.
Freshman
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Department of Surgery, University of California, Davis, Sacramento 95817.
Battistella
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Matteucci
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Wisner
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DH
D000208:Acute Disease; D000818:Animals; D006259:Craniocerebral Trauma / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006400:Hematocrit; D006439:Hemodynamics; D006863:Hydrogen-Ion Concentration; D007427:Intracranial Pressure; D008353:Mannitol / Q000627:therapeutic use*; D009994:Osmolar Concentration; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*; D012756:Sheep
D012462:Saline Solution, Hypertonic; D008353:Mannitol