OSMOTHERAPY FOR INCREASED INTRACRANIAL-PRESSURE - COMPARISON BETWEEN MANNITOL AND GLYCEROL

Osmotic agents are still the most common treatment for controlling int racranial hypertension (ICH). Mannitol, glycerol, sorbitol, and hypert onic serum saline are the agents currently available. This work was de signed to compare mannitol and glycerol in a similar population of bra in injured patients, randomly divided into two groups of eight. The fo llowing mean day parameters were obtained: number of infusions, hydric balance, mean arterial pressure (MAP), and intracranial pressure (ICP ). Cerebral perfusion pressure (CPP) was calculated. Brain computed to mographies (CT) were obtained on arrival, at follow-up whenever justif ied and at discharge. For comparison of both groups a modified therape utic intensity level (mTIL) was used. Both agents induced a statistica lly equally effective decrease on ICP and increase on CPP evaluated at one and two hours post infusion but the mean day mTIL showed a statis tically significant difference in favour of glycerol. The possible exp lanations of this difference are discussed. According to our results m annitol would be most indicated as a bolus to control sudden rises in ICP whereas glycerol would be most indicated as a basal treatment.