Effects of hypertonic saline solution and mannitol in acute intracranial hypertension in rabbits

THESES

Effects of hypertonic saline solution and mannitol in acute intracranial hypertension in rabbits (Abstract)^*. Dissertation. Recife, 2006.

Joacil Carlos da Silva Jr^**

INTRODUCTION: Medical management of brain edema and elevated intracranial pressure (ICP) is a crucial challenge in neurosurgical practice. Depending on the cause, the treatments for brain edema fall into three categories: stabilization of the blood brain barrier, depletion of brain water, and surgical decompression. Although mannitol is the mainstay of hyperosmolar therapy hypertonic saline (HS) is emerging as an effective alternative to traditional osmotic agents.

METHODS: Experimental elevated ICP (50 mmHg) was induced in rabbits using an intracranial balloon. The effects of mannitol and hypertonic saline (NaCl 10%) was compared in this specific physiopathological model. Twelve animals were divided in three groups (control, HS and mannitol) according to intravenous administration of NaCl 0,9%, NaCl 10% or mannitol 20% five minutes after the elevation of ICP. The doses of NaCl 10% and mannitol 20% were iso-osmolar. During 90 minutes continuous recording of ICP, mean arterial pressure (MAP) and cerebral perfusion pressure (CPP) was realized.

RESULTS: The control group had a median survival of only 53 minutes, significantly lower than the treated groups (p=0.0002). There was statistical difference between mannitol and HS, the NaCl 10% group had lower values of ICP (p=0.0116) and higher values of MAP (p<0.0001) and CPP (p<0.0001).

CONCLUSION: The findings demonstrate higher efficacy of the NaCl 10% treatment in this comparison with mannitol 20%. Further efforts should be directed toward development of clinical studies using iso-osmotic doses of mannitol and HS in specific etiologies of intracranial hypertension.

Key words: intracranial pressure, hypertonic saline, mannitol.

*

Efeitos de solução salina hipertônica e manitol em coelhos com hipertensão intracraniana aguda (Resumo). Dissertação de Mestrado, Universidade Federal de Pernambuco–UFPE (Área Neuropsiquiatria–Neurociência Experimental). Orientador: Hildo Rocha Cirne de Azevedo Filho.

Publication Dates

• Publication in this collection
  11 Apr 2008
• Date of issue
  Sept 2007