Abstract
Objective To investigate effect of sustained intracranial pressure (ICP) monitoring in mannitol therapy for kidney function conservation after craniocerebral trauma.Methods A retrospective comparison was conducted on 168 patients with craniocerebral trauma treated between January 2010 and January 2012.The patients were divided into ICP monitoring group (ICP group,77patients) and non-ICP monitoring group (control group,91 patients).Changes of cystatin C,creatinine and urea in plasma were detected dynamically.Data like mannitol dosage,hospital days and GOS score at postoperative 6 months were documented.Results Two groups showed no significant differences regarding in-hospital injury condition,renal function as well as age and gender distribution.Rate of renal failure of control group was 2.2 times more than that of ICP group (P < 0.05).Mannitol dosage of ICP group only accounted for 27.35% of that of control group,ie,(443 ± 133) g:(1 620 ±412) g (P <0.01).Frequency of mannitol use of ICP group was obviously less than that of control group,ie,(4.8 ±3.8) days vs (7.2 ± 2.3) days (P < 0.01).At 6 months postoperatively,GOS score of ICP group was significantly better than that of control group (P < 0.05).Plasma levels of cystatin C and creatinine at days 7,14 and 21 and plasma levels of urea at day 14 were significantly lower of ICP group,when compared with control group (P < 0.05).Conclusion ICP monitoring significantly reduces the dosage and duration of mannitol therapy for craniocerebral trauma and effectually prevents and declines the occurrence of renal failure following craniocrebral trauma. Key words: Craniocerebral trauma; Intracranical pressure ; Mannitol; Kidney function
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