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Mannitol is used intravenously to reduce acutely raised intracranial pressure until more definitive treatment can be applied, [16] e.g., after head trauma. While mannitol injection is the mainstay for treating high pressure in the skull after a bad brain injury, it is no better than hypertonic saline as a first-line treatment.
Compared to mannitol, there's evidence that the improvement in ICP, cerebral blood flow, and CPP due to administration of hypertonic saline lasts longer. In addition, hypertonic saline also shows significant effect in improving blood rheology such as hematocrit and shear rate at the level of the internal carotid artery (ICA). [6]
Hypertonic saline may be preferable to mannitol in persons with hypovolemia or hyponatremia. [44] Mannitol is an alcohol derivative of simple sugar mannose, and is historically the most commonly used osmotic diuretic. [3] Mannitol acts as an inert solute in the blood, decreasing ICP through osmosis as discussed above. [44]
There are multiple methods of washing red cells. [2] These can include automated or manual methods. They can use centrifugation or centrifugation-free methods. [2] The red cells can be re-suspended in saline or other types of special preservative solutions for red cells, such as SAGM (saline, adenine, glucose and mannitol).
Such agents can be used to reduce intracranial pressure and to promote prompt removal of renal toxins. The prototypical osmotic diuretic is mannitol. [5] Mannitol lowers the intra cranial pressure through two effects in the brain. The first, rheological effect, reduces blood viscosity, and promotes plasma expansion and cerebral oxygen delivery.
If there is an intact blood–brain barrier, osmotherapy (mannitol or hypertonic saline) may be used to decrease ICP. [33] It is unclear whether mannitol or hypertonic saline is superior, or if they improve outcomes. [34] [35] Struggling, restlessness, and seizures can increase metabolic demands and oxygen consumption, as well as increasing ...
The most commonly used crystalloid fluid is normal saline, a solution of sodium chloride at 0.9% concentration, which is close to the concentration in the blood . [3] Ringer's lactate or Ringer's acetate is another isotonic solution often used for large-volume fluid replacement.
Saline solution for irrigation. Normal saline (NSS, NS or N/S) is the commonly used phrase for a solution of 0.90% w/v of NaCl, 308 mOsm/L or 9.0 g per liter. Less commonly, this solution is referred to as physiological saline or isotonic saline (because it is approximately isotonic to blood serum, which makes it a physiologically normal solution).