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Pathophysiology and differentiated hyperosmolary therapy in cerebral edema in patients with craniocerebral injury
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| Author:
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VYACHESLAV AVAKOV, NEMAT IBRAGIMOV, TEMUR MALIK MUROTOV, LAZIZ KENZHAEV, RUSLAN DJUMABAEV
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| Abstract:
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To study the pathophysiological aspects of cerebral edema and compare the effectiveness of using 15% mannitol solution and hypertonic 3.5%, 7%, 10% sodium chloride solution in the complex treatment of patients with head injury.
Material and methods: 90 patients from 18 years old to 68 years old with various traumatic brain injuries and inhibition of consciousness level from 4 to 13 points on the Glasgow coma scale were examined.
Results: infusion of mannitol at the indicated dosage reduced ICP after 30 minutes by 42, 3%, and after 120 minutes it remained below the initial data by 23.9%. Infusion of a 3.5% NaCl solution already by the 30th minute led to a decrease of ICP by 48.6%, and by the end of 120 minutes the ICP remained below the initial data by 35.9%. Infusion of a 7% NaCl solution already by the 30th minute led to a decrease in ICP by 55.4%, and by the end of 120 minutes the ICP remained below the initial data by 39.9%. Infusion of a 10% NaCl solution already by the 30th minute led to a decrease in ICP by 58.4%, and by the end of 120 minutes the ICP remained below the initial data by 45.9%.
Conclusions: the decrease in ICP within 30 and 120 minutes after the introduction of hyperosmolar solutions is more pronounced with iv administration of 3.5%, 7%, 10% NaCl solution relative to 15% Mannitol in calculated dosages, which should be borne in mind in patients with concomitant cardiac and renal pathology.
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| Keyword:
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traumatic brain injury, hypertonic saline, mannitol, intracranial pressure, cerebral edema, CPP
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.12.02.0026
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| Download:
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