title: Efficacy and Safety of Continuous Micro-Pump Infusion of 3% Hypertonic Saline combined with Furosemide to Control Elevated Intracranial Pressure.
abstract: BACKGROUND
  Elevated intracranial pressure is one of the most common problems in patients with diverse intracranial disorders, leading to increased morbidity and mortality. Effective management for increased intracranial pressure is based mainly on surgical and medical techniques with hyperosmolar therapy as one of the core medical treatments. The study aimed to explore the effects of continuous micro-pump infusions of 3% hypertonic saline combined with furosemide on intracranial pressure control.
  
  
  METHODS
  We analyzed data on 56 eligible participants with intracranial pressure >20 mmHg from March 2013 to July 2014. The target was to increase and maintain plasma sodium to a level between 145 and 155 mmol/L and osmolarity to a level of 310 to 320 mOsmol/kg.
  
  
  RESULTS
  Plasma sodium levels significantly increased from 138±5 mmol/L at admission to 151±3 mmol/L at 24 h (P<0.01). Osmolarity increased from 282±11 mOsmol/kg at baseline to 311±8 mOsmol/kg at 24 h (P<0.01). Intracranial pressure significantly decreased from 32±7 mmHg to 15±6 mmHg at 24 h (P<0.01). There was a significant improvement in CPP (P<0.01). Moreover, central venous pressure, mean arterial pressure, and Glasgow Coma Scale slightly increased. However, these changes were not statistically significant.
  
  
  CONCLUSIONS
  Continuous infusion of 3% hypertonic saline + furosemide is effective and safe for intracranial pressure control.
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Yuqian
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Yanlong
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Bao
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Xingye
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Hongyu
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Wei
authors.initials: W
authors.lastname: Fang
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Bo
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Boliang
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Guodong
authors.initials: G
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery, Tangdu Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, China (mainland).
authors.forename: Lihong
authors.initials: L
authors.lastname: Li
mesh_terms: D000368:Aged; D001930:Brain Injuries / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005665:Furosemide / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007260:Infusion Pumps; D019586:Intracranial Hypertension / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D012189:Retrospective Studies; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage* / Q000009:adverse effects; D012964:Sodium / Q000097:blood
chemical_list: D012462:Saline Solution, Hypertonic; D005665:Furosemide; D012964:Sodium