The early response of mannitol infusion in traumatic brain injury.
BACKGROUND
Mannitol was used in traumatic brain injury but controversy about the onset and duration.


METHODS
Clinical observational study.


METHODS
Fourteen traumatic brain injured patients with a Glasgow Coma Scale (GCS) score < or = 8 were enrolled. Group I patients (n = 8) with intracranial pressure (ICP) < 20 mmHg, and group II patients (n = 6) with ICP > or = 20 mmHg underwent transcranial Doppler (TCD) monitoring and blood samples were drawn every 5 minutes during the post-operation period. Several parameters were compared with statistical analysis between both groups.


RESULTS
The ICP declined during a 30-minute recording in both groups and the decline of ICP was significant (p < 0.05) at the 10-minute interval in group II. The decline of hemoglobin (Hb) and oxygen content (CaO2), increase of venous pressure (CVP) and 02-transport ability (CeDO2) at 10-minute were also statistically significant (p < 0.05) in group II as compared to the group I. Using a regression model between both comparisons, several parameters were statistically different at the 10-minute interval after mannitol infusion.


CONCLUSIONS
The dynamic responses can happen as early as 5-10 minutes after mannitol infusion, and had a greater effect on traumatic brain injury patients with ICP > or = 20 mmHg. It demonstrated a significant dynamic difference between both groups. All these changes can be monitored by TCD and peripheral blood tests.
Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan.
Kao-Chang
KC
Lin
Chih-Ho
CH
Chou
Wei-Lung
WL
Chang
Der-Shin
DS
Ke
Jinn-Rung
JR
Kuo
D000328:Adult; D001812:Blood-Brain Barrier; D001930:Brain Injuries / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007427:Intracranial Pressure / Q000187:drug effects; D008297:Male; D008353:Mannitol / Q000008:administration & dosage*; D008875:Middle Aged; D017585:Ultrasonography, Doppler, Transcranial; D014655:Vascular Resistance / Q000187:drug effects
D008353:Mannitol