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| Effect comparation of isosmotic dose of 7.5% hypertonic saline and 20% mannitol on intracranial pressure reduction |
| HUO Shengjie ZHANG Wenqi LIU Jindao WANG Jiangfeng CHEN Chen LI Hao DONG Tao▲ |
| Department of Neurosurgery, the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Shaanxi Province, Xianyang 712000, China |
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Abstract Objective To compare the effect of isosmotic dose of 7.5% hypertonic saline and 20% mannitol on intracranial pressure (ICP) reduction. Methods The data of patients with intracranial hypertension caused by severe traumatic brain injury admitted to the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2015 to June 2018 were retrospectively analyzed. Among them, 30 cases met the inclusion criteria were collected and divided into 7.5% hypertonic saline group (15 cases) and 20% mannitol group (15 cases) according to hypertonic therapy. The reduction of ICP, onset time, effective duration, minimum ICP time, cerebral perfusion pressure (CPP), mean arterial pressure (MAP) and central venous pressure (CVP) were compared between two groups. Serum sodium concentration and plasma osmotic pressure were analyzed before treatment and 1 and 3 hours after treatment between two groups. Results After treatment, ICP in 7.5% hypertonic saline group decreased more than that in 20% mannitol group, the onset time and effective duration in 7.5% hypertonic saline group were longer than that in 20% mannitol group, and the minimum ICP time in 7.5% hypertonic saline group was shorter than that in 20% mannitol group, the differences were statistically significant (all P < 0.05). CPP and MAP of 7.5% hypertonic saline group after treatment were higher than those of 20% mannitol group, the differences were statistically significant (P < 0.05). There was no significant difference in CVP between two groups after treatment (P > 0.05). There were statistically significant differences in plasma osmotic pressure and sodium concentration between two groups before treatment and 1 and 3 hours after treatment (all P < 0.05). There were statistically significant differences in plasma osmotic pressure and sodium concentration between two groups 1 and 3 hours after treatment (all P < 0.05). Conclusion ICP reduction effect of 7.5% hypertonic saline is better than that of 20% mannitol.
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