Mannitol Versus Hypertonic Saline Solution in the Treatment of Elevated Intracranial Pressure

19:43 EDT 2nd September 2014 | BioPortfolio

Summary

The purpose of this study is to determine whether mannitol is as effective as hypertonic saline solution in the treatment of elevated intracranial pressure in patients with brain injury.

Description

Elevation of intracranial pressure (ICP) to more than 20 mmHg plays a major role in the worsening of the neurological status through the impairment of brain perfusion. In an effort to reduce the intensity and the time spent with increased ICP, infusion of mannitol has been the recommended first-line agent for years. The growing interest in the use of hypertonic saline solutions (HSS) in this clinical setting has, however, challenged the use of mannitol. Because mannitol and HSS may differ regarding their clinically relevant mechanisms of action, there is a need to determine which osmotic compound could be the most appropriate in patients with elevated ICP. We conduct thus a parallel, randomized controlled trial comparing the effects of an equimolar infusion of 20% mannitol or 7.45% HSS without colloid in patients with elevated ICP. The primary end point of this trial is the magnitude of ICP and of cerebral perfusion pressure (CPP) changes following treatment during a study period of 120 min.

Study Design

Allocation: Randomized, Control: Active Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Conditions

Intracranial Hypertension

Intervention

20% mannitol, 7.45% hypertonic saline solution

Location

Hopital Michallon
Grenoble
France
38043

Status

Completed

Source

University Hospital, Grenoble

Results (where available)

View Results

Links

Clinical Trials [1079 Associated Clinical Trials listed on BioPortfolio]

Double Blind Study of Hypertonic Saline vs Mannitol in the Management of Increased Intracranial Pressure (ICP).

The study goal is to compare the management of increased intra-cranial pressure (ICP) using 3% hypertonic saline vs. mannitol (given in same osmolar loads). Primary hypothesis: 1. ...

Hypertonic Saline 75% vs Mannitol 20%

The purpose of this study is to evaluate the effect of Hypertonic Saline 7.5% vs Mannitol 20% on brain bulk (using a 4 point scale), intracranial pressure (subdural catheter)and the change...

Mannitol Versus Hypertonic Saline to Treat Intracranial Hypertension (ICHT) After Severe Traumatic Brain Injury (TBI) : Comparative Effects on PtiO2 and Microdialysis Values

The purpose of this study is to determine whether hypertonic saline is as much effective as mannitol to treat intracranial hypertension after traumatic brain injury and has at least the sa...

Cerebral Hemodynamic Effects of Hypertonic Solutions in Severely Head-Injured Patients

This is a clinical study comparing the physiologic effects of two hypertonic solutions (mannitol, hypertonic saline) with a particular emphasis on changes in cerebral blood flow in patient...

Hypertonic Resuscitation Following Traumatic Brain Injury

The purpose of this study is to determine if hypertonic saline with and without dextran can improve neurologic outcomes in victims of severe traumatic brain injury (TBI). Injury and lost ...

PubMed Articles [7175 Associated PubMed Articles listed on BioPortfolio]

A Comparison of Equivolume, Equiosmolar Solutions of Hypertonic Saline and Mannitol for Brain Relaxation in Patients Undergoing Elective Intracranial Tumor Surgery: A Randomized Clinical Trial.

Hyperosmolar solutions have been used in neurosurgery to modify brain bulk and prevent neurological deterioration. The purpose of the study was to compare the effects of equivolume, equiosmolar soluti...

Small volume resuscitation with hypertonic sodium chloride solution in cattle undergoing surgical correction of abomasal volvulus.

A randomized clinical trial was conducted to compare the efficacy of rapid intravenous (IV) infusion of a 7.2% hypertonic saline solution with that of continuous application of an isotonic solution in...

Post-traumatic multimodal brain monitoring: response to hypertonic saline.

Emerging evidence suggests that hypertonic saline (HTS) is efficient in decreasing intracranial pressure (ICP). However there is no consensus about its interaction with brain hemodynamics and oxygenat...

Rebound Intracranial Hypertension: A Complication of Epidural Blood Patching for Intracranial Hypotension.

SUMMARY:Rebound intracranial hypertension is a complication of epidural blood patching for treatment of intracranial hypotension characterized by increased intracranial pressure, resulting in potentia...

The physiological effects of hyperosmolar resuscitation: 5% vs 3% hypertonic saline.

Use of 5% normal saline (NS) is gaining renewed interest. The primary aim of our study was to compare the physiological effects after the administration of different concentrations of hypertonic salin...

Medical and Biotech [MESH] Definitions

Hypertonic sodium chloride solution. A solution having an osmotic pressure greater than that of physiologic salt solution (0.9 g NaCl in 100 ml purified water).

Solution that is usually 10 percent glucose but may be higher. An isotonic solution of glucose is 5 percent.

Increased pressure within the cranial vault. This may result from several conditions, including HYDROCEPHALUS; BRAIN EDEMA; intracranial masses; severe systemic HYPERTENSION; PSEUDOTUMOR CEREBRI; and other disorders.

Solutions that have a greater osmotic pressure than a reference solution such as blood, plasma, or interstitial fluid.

Phosphoric acid esters of mannitol.

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