HIGH COLLOID ONCOTIC THERAPY FOR CONTUSIONAL BRAIN EDEMA

We investigated whether prolonged high colloid oncotic therapy for two weeks can suppress contusional brain edema. Eighteen patients with ce rebral contusion were randomly divided into two groups of patients rec eiving high oncotic pressure (HOP; 26-30 mmHg) treatment and those rec eiving normal oncotic pressure (NOP; 22-26 mmHg) treatment. Oncotic pr essure was maintained for two weeks with administration of a 25% album in solution with additional use of furosemide. Edema volume was calcul ated by summation of all measured low-density areas in each CT slice m ultiplied by 1.0 cm of slice of thickness. We expressed contusional br ain edema volume as a percent increase based on each patient's initial CT. The mean percent increase of contusional brain edema in the NOP g roup was significantly higher than that in the HOP group at 9-15 days (208.9% and 14.0%, respectively) and 16-25 days (188.8% and 10.0%, res pectively). There were no complications such as heart failure or renal failure during treatment. All the patients in the HOP group recovered with minimal or no neurological deficit. On the other hand, 30% of pa tients in the NOP group remained in poor condition. With frequent meas urement of oncotic pressure and adjustment of fluids and electrolytes, continuous oncotic therapy for two weeks effectively and safely reduc ed contusional brain edema.