The early response of mannitol infusion in traumatic brain injury.

Abstract

Mannitol was used in traumatic brain injury but controversy about the onset and duration. Clinical observational study. Fourteen traumatic brain injured patients with a Glasgow Coma Scale (GCS) score < or = 8 were enrolled. Group I patients (n = 8) with intracranial pressure (ICP) < 20 mmHg, and group II patients (n = 6) with ICP > or = 20 mmHg underwent transcranial Doppler (TCD) monitoring and blood samples were drawn every 5 minutes during the post-operation period. Several parameters were compared with statistical analysis between both groups. The ICP declined during a 30-minute recording in both groups and the decline of ICP was significant (p < 0.05) at the 10-minute interval in group II. The decline of hemoglobin (Hb) and oxygen content (CaO2), increase of venous pressure (CVP) and 02-transport ability (CeDO2) at 10-minute were also statistically significant (p < 0.05) in group II as compared to the group I. Using a regression model between both comparisons, several parameters were statistically different at the 10-minute interval after mannitol infusion. The dynamic responses can happen as early as 5-10 minutes after mannitol infusion, and had a greater effect on traumatic brain injury patients with ICP > or = 20 mmHg. It demonstrated a significant dynamic difference between both groups. All these changes can be monitored by TCD and peripheral blood tests.