Mannitol or hypertonic saline for intracranial hypertension? A point of view.
Osmotically active solutions, particularly mannitol, havebeen used for more than 30 years in the treatment ofintracranial hypertension. Recently hypertonic saline hasemerged as an alternative to mannitol. Both solutions areused worldwide, and their indications and long-term sideeffects are well known. More recently, knowledge abouttheir effects has increased, both limiting and expandingtheir clinical use. Here, we compare the systemic andcerebral effects of mannitol and hypertonic saline, as well astheir side effects and complications. Finally, we makerecommendations about their clinical use.
Castillo
Luis B
LB
Departamento de Medicina Intensiva, Facultad de Medicina, Universidad Católica de Chile, Santiago, Chile. castillo@med.puc.cl
Bugedo
Guillermo A
GA
Paranhos
Jorge L
JL
D001812:Blood-Brain Barrier / Q000187:drug effects; D002302:Cardiac Output; D003422:Critical Care; D004234:Diuretics, Osmotic / Q000627:therapeutic use*; D006801:Humans; D019586:Intracranial Hypertension / Q000139:chemically induced / Q000517:prevention & control*; D008353:Mannitol / Q000627:therapeutic use*; D008833:Microcirculation; D009994:Osmolar Concentration; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use*
D004234:Diuretics, Osmotic; D012462:Saline Solution, Hypertonic; D008353:Mannitol