Abstract
Background: There are therapies to lower intracranial pressure (ICP) including head elevation, hyperventilation, diuretics injection, intravenous mannitol, hypothermia, cerebrospinal fluid drainage, and cerebral resection in neurosurgical patients. However in recent reports, hyperventilation followed by mannitol administration may lead to cerebral ischemia. Therefore, we investigated the effect of 0.5 -1.0 g/kg mannitol administration on jugular venous oxygen saturation () and cerebral arterialjugular venous oxygen content difference () at 25-30 mmHg and 35-40 mmHg in patients undergoing neurosurgery. Methods: We studied 17 patients undergoing neurosurgery in the Ajou University Hospital. Anesthesia was induced with fentanyl, midazolam, thiopental, and vecuronium, and maintained with -Air-Isoflorane, a continuous infusion of fentanyl, and vecuronium. Patients were divided into two groups. Group 1 (n = 10) which is 25-30 mmHg and Group 2 (n = 7) which is 35-40 mmHg by controlling ventilator. Measurements of and in following time intervals: I = preinjection of mannitol, II = postinjection 20 minutes of mannitol, III = postinjection 40 minutes of mannitol were obtained for each group. 0.5-1.0 g/kg mannitol was administered intravenously just at duramater opening. Results: Hemodynamics and hematologics were not significantly different among the two groups. of each group are as follows; Group 1; I (70.3 8.1%), II (66.3 6.9%), III (69.1 7.9%) and Group 2; I (78.6 7.4%), II (75.1 8.1%), III (76.0 11.2%). Hyperventilation significantly decreased . was not significantly different but in II was significantly decreased compared with I and III in Group 1 (20% patients). Conclusions: Mannitol produced a change of and during hyperventilation. Therefore, intravenous mannitol during hyperventilation should be given cautiously according to the patients status because it may cause cerebral ischemia in critical patients.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
