Blood circulation changes after application of 3 ％ hypertonic saline vs 20 ％ mannitol in intracranial hypertensive patients

Abstract

Objective To observe the changes in hemodynamics and internal environments after application of 3％ hypertonic saline (HS) vs 20％ mannitol (M) in intracranial hypertensive patients.Methods Sixty patients with intracranial hypertension were randomly allocated to HS group (n =30) and M group (n =30),receiving 3％ HS and 20％ M respectively.Heart rate ( HR),mean arterial pressure (MAP),stroke volume index (SVI),stroke volume variation (SVV),central venous pressure (CVP),systemic vascular resistance index ( SVRI ) and urine output were measured before injection (T0 ),immediate (T1),5 min (T2),15 min (T3),30 min (T4),45 min (T5),60 min (T6),90 min (T7),and 120 min (T8 ) after injection.The radial artery blood was collected for measuring the pH,Na+,K+,Ca2+,blood lactate (BLA) at T0 and T8.Results ( 1 ) In HS group,the levels of SVV were decreased,and those of SVI,CVP and MAP increased at F1 -T8 as compared with T0 ( P ＜ 0.05 ) ; HR was increased at T1 and decreased at T6-T8 (P ＜ 0.05 ); SVRI was decreased at T1-T5 (P＜0.05 ); (2) As compared with T0,the levels of blood Na + were increased and BLA contents decreased at T8 in HS group ( P ＜ 0.05 );(3) There was significant difference in the levels of SVV,SVI,CVP,MAP,HR and SVRI between HS group at T5-T8 and M group ( P ＜0.05 ) ; (4) The hydrouria in M group at T1-T8 was greater than in HS group (P＜0.05).Conclusions 3％ HS is superior to 20％ M in maintaining circulation stability and improving internal environments during operation in patients with intracranial hypertension. Key words: Intracranial hypertension; Hypertonic saline; Mannitol; Hemodynamics