Major Clinical and Physiological Benefits of Early High Doses of Mannitol for Intraparenchymal Temporal Lobe Hemorrhages with Abnormal Pupillary Widening: A Randomized Trial

@article{Cruz2002MajorCA,
  title={Major Clinical and Physiological Benefits of Early High Doses of Mannitol for Intraparenchymal Temporal Lobe Hemorrhages with Abnormal Pupillary Widening: A Randomized Trial},
  author={Julio Cruz and Giulio Minoja and Kazuo Okuchi},
  journal={Neurosurgery},
  year={2002},
  volume={51},
  pages={628-638}
}
OBJECTIVE We evaluated long-term clinical outcomes and postoperative physiological findings in acutely comatose patients with nonmissile surgical intraparenchymal temporal lobe hemorrhages and abnormal pupillary widening who received early preoperative high-dose mannitol (HDM) versus conventional dose mannitol treatment in the emergency room. METHODS One hundred forty-one adult patients with traumatic, nonmissile, acute, intraparenchymal temporal lobe hemorrhages associated with early abnormal… 
Successful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial.
TLDR
Ultra-early high-dose mannitol administration in the emergency room is the first known treatment strategy significantly to reverse recent clinical signs of impending brain death, and also to contribute directly to improved long-term clinical outcomes for these patients who have previously been considered unsalvageable.
High-dose mannitol.
TLDR
There was a dramatic difference in the improvement in pupillary response in patients who received the higher dose of mannitol, and this group had a much higher rate of favorable outcomes at 6 months compared with a 9.5% favorable outcome in the group receiving conventionalMannitol therapy.
Modern treatment options for intracerebral hemorrhage
TLDR
The Surgical Trial in Intracerebral Hemorrhage reported results from an international randomized trial of 1033 patients who did not show benefit for surgical evacuation of ICH, compared with medical therapy alone, and two randomized controlled trials provided crucial evidence regarding surgical and medical intervention for acute ICH intervention.
Effects of decompressive surgery in patients with severe traumatic brain injury and bilateral non-reactive dilated pupils.
TLDR
Outcome in patients with BNDP after STBI may not always be fatal or poor, especially in patientswith admission GCS score of 6 or 7, and rapid DS may increase the chance of functional survival.
Effects of a Single Mannitol Bolus on Cerebral Hemodynamics in Intracerebral Hemorrhage: A Transcranial Doppler Study
TLDR
A single bolus of mannitol modified cerebral hemodynamics in patients with ICH, increasing flow velocities on the affected MCA, may be a consequence of reduced edema in the perilesional areas.
Comparison of Equimolar Doses of Mannitol and Hypertonic Saline for the Treatment of Elevated Intracranial Pressure After Traumatic Brain Injury
TLDR
Hypertonic saline is more effective than mannitol for reducing intracranial pressure (ICP) after traumatic brain injury (TBI) in cases of TBI.
Réunion de neuroanesthésie-réanimation. Prise en charge anesthésique du patient en hypertension intracrânienne aiguë
TLDR
If a long-lasting extracranial surgery is necessary, ICP should be monitored and treatment of ICH should have been instituted before, and high-dose mannitol administration may be considered a better option than conventional doses, especially before emergency evacuation of a cerebral mass lesion.
Osmolar therapy in pediatric traumatic brain injury*
TLDR
Hypertonic saline and mannitol are used less in infants than in older children, and the substantial amount of sustained osmolar therapy without intracranial pressure monitoring suggest opportunities to improve the quality of pediatric traumatic brain injury care.
Osmotherapy for Intracranial Hypertension: Mannitol Versus Hypertonic Saline
  • M. Fink
  • Medicine, Sociology
    Continuum
  • 2012
TLDR
Both mannitol and hypertonic saline are effective and have an acceptable risk profile for use in the treatment of elevated intracranial pressure secondary to brain edema.
Mannitol for acute traumatic brain injury.
TLDR
There are insufficient data to recommend one form of mannitol infusion over another, and ICP-directed treatment for raised ICP may have a beneficial effect on mortality when compared to pentobarbital treatment.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 36 REFERENCES
Improving Clinical Outcomes from Acute Subdural Hematomas with the Emergency Preoperative Administration of High Doses of Mannitol: A Randomized Trial
TLDR
Emergency preoperative HDM administration was associated with improved clinical outcomes for patients with acute subdural hematomas, and preoperative improvement of abnormal pupillary widening and better postoperative control of intracranial hypertension and associated relative cerebral hyperperfusion seemed to be relevant factors associated withImproved outcomes.
Adverse effects of pentobarbital on cerebral venous oxygenation of comatose patients with acute traumatic brain swelling: relationship to outcome.
  • J. Cruz
  • Medicine
    Journal of neurosurgery
  • 1996
Global cerebrovenous oxygenation was evaluated before and after intravenous administration of pentobarbital sodium for the management of refractory intracranial hypertension in 151 comatose patients
Cerebral Extraction of Oxygen and Intracranial Hypertension in Severe, Acute, Pediatric Brain Trauma: Preliminary Novel Management Strategies
TLDR
In severe, acute, non-missile pediatric brain trauma, phasic physiological patterns demonstrated an association between the development of intracranial hypertension and relative cerebral hyperperfusion (decreased global CEO2), especially after postinjury Day 1.
Relationship between early patterns of cerebral extraction of oxygen and outcome from severe acute traumatic brain swelling: cerebral ischemia or cerebral viability?
  • J. Cruz
  • Medicine
    Critical care medicine
  • 1996
TLDR
Outcome at 6 months postinjury was significantly better in patients with initially increased cerebral extraction of oxygen than in those patients with normal or decreased values, suggesting global cerebral viability rather than cerebral ischemia in patientsWith acute traumatic diffuse brain swelling.
The first decade of continuous monitoring of jugular bulb oxyhemoglobinsaturation: management strategies and clinical outcome.
  • J. Cruz
  • Medicine
    Critical care medicine
  • 1998
TLDR
In patients with severe acute brain trauma and intracranial hypertension associated with compromised cerebrospinal fluid spaces, monitoring and managing cerebral extraction of oxygen in conjunction with cerebral perfusion pressure result in better outcome than when cerebral perfusions pressure is managed alone.
Relationship of early cerebral blood flow and metabolism to outcome in acute head injury.
TLDR
Age, initial Glasgow Coma Scale score, and occurrence of intracranial hypertension were each found to be predictive of outcome, thus confirming previous reports, and the CMRO2 was relatively independent of the other prognostic indicators and contributed most to the prediction.
Cerebral lactate‐oxygen index in acute brain injury with acute anemia: Assessment of false versus true ischemia
TLDR
In acute brain injury with acute anemia, global cerebral ischemia is a rare finding, however, false cerebral isChemia may be frequently found, if assessed by the lactate-oxygen index, because the denominator of the index frequently decreases as a function of decreasing hemoglobin, thus yielding false calculated ischemic high values for lactate and oxygenation despite normal cerebral oxygenation and lactate production.
Combined continuous monitoring of systemic and cerebral oxygenation in acute brain injury: Preliminary observations
  • J. Cruz
  • Medicine
    Critical care medicine
  • 1993
ObjectiveTo continuously evaluate the relationship between global systemic and cerebral oxygenation during temporary profound hypocapnia, which was attempted for prompt management of posttraumatic
Cerebral blood flow and metabolism in comatose patients with acute head injury. Relationship to intracranial hypertension.
TLDR
Hyperemia was found at all age levels (15 to 85 years), and there was a highly significant association between hyperemia and the occurrence of intracranial hypertension, defined as an intrusion above 20 mm Hg.
Hypophosphatemia and hypomagnesemia induced by cooling in patients with severe head injury.
TLDR
Induced Hypothermia is associated with severe electrolyte depletion, which is at least partly due to increased urinary excretion through hypothermia-induced polyuria, which may be the mechanism through which induced hypotheria can lead to arrhythmias.
...
1
2
3
4
...