Osmotic and osmotic-loop diuresis in brain surgery. Effects on plasma and CSF electrolytes and ion excretion.

@article{Schettini1982OsmoticAO,
  title={Osmotic and osmotic-loop diuresis in brain surgery. Effects on plasma and CSF electrolytes and ion excretion.},
  author={Alfonso Schettini and B Stahurski and Harold F. Young},
  journal={Journal of neurosurgery},
  year={1982},
  volume={56 5},
  pages={
          679-84
        }
}
In 22 patients to be operated on for brain tumors or cerebral aneurysms, the effect of osmotic diuresis was compared with that of osmotic-loop diuresis on plasma and cerebrospinal fluid (CSF) electrolytes, and water and ion excretion. Mannitol or mannitol plus furosemide were used to reduce brain bulk. After treatment with thiopental and hyperventilation, patients received randomly a rapid infusion of mannitol (1.4 gm/kg), or mannitol (1.4 gm/kg) plus furosemide (0.3 mg/kg). Brain shrinkage was… 
View on PubMed
thejns.org
49 Citations
Highly Influential Citations
2
Background Citations
6
Methods Citations
1
Results Citations
2

49 Citations

Citation Type

Citation Type

Effect of mannitol and furosemide on blood-brain osmotic gradient and intracranial pressure.
TLDR
The results from this present study suggest that the distal loop diuretics in a dose of less than 1.0 mg/kg act synergistically with mannitol by causing preferential excretion of water over solute in the renal distal tubule, and thereby sustaining the osmotic gradient initially established by theMannitol infusion.
Effect of Mannitol and Furosemide on Plasma Osmolality and Brain Water
TLDR
The doses of mannitol and furosemide utilized were much larger than clinically applicable doses and were selected to maximize the ability to detect effect on brain water.
The Effect of Furosemide on Intravascular Volume Status and Electrolytes in Patients Receiving Mannitol: An Intraoperative Safety Analysis
TLDR
Despite an increase in urine output by as much as 67%, adding low-dose furosemide to mannitol does not seem to produce significant electrolyte derangements or hypovolemia compared with the administration ofMannitol alone.
The effect of high-dose mannitol on serum and urine electrolytes and osmolality in neurosurgical patients
TLDR
The clinically most important change is the increase in serum potassium with high-dose mannitol, and the exact mechanism of this increase remains unclear.
Effective and safe mannitol administration in patients undergoing supratentorial tumor surgery: A prospective, randomized and double blind study
Effect on intracranial pressure of furosemide combined with varying doses and administration rates of mannitol.
TLDR
Results indicated that rapid administration produced higher peak serum concentrations of mannitol and more profound lowering of ICP than the same dose delivered at slower rates.
Treatment of acute hyponatremia: Ensuring the excretion of a predictable amount of electrolyte-free water
TLDR
The combined use of mannitol and a loop diuretic caused the excretion of a predictable volume of EFW because the urine was iso-osmotic to plasma and contained all the administered mann Capitolitol.
Variation in Osmotic Response to Sustained Mannitol Administration
TLDR
Multivariate analysis found that younger age, lower weight-adjusted mannitol dose, and more negative fluid balance were associated with lack of osmotic response.
Influence of Mannitol and Furosemide, Alone and in Combination, on Brain Water Content after Fluid Percussion Injury
TLDR
Mannitol increased plasma osmolality and reduced water content of the injured and contralateral hemispheres, whereas the authors observed no effect of furosemide when given either alone or in combination with mannitol.
Comparison of Equivolume, Equiosmolar Solutions of Mannitol and Hypertonic Saline with or without Furosemide on Brain Water Content in Normal Rats
TLDR
Mannitol reduced brain water content to a greater extent over the entire course of the 5-h experiment, and when furosemide was added to HS, the brain-dehydrating effect could not be distinguished from that of mannitol.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 20 REFERENCES
Effects of diuretics on cerebrospinal fluid formation and potassium movement.
  • F. Domer
  • Biology, Chemistry
    Experimental neurology
  • 1969
Diuretic synergy in the treatment of acute experimental cerebral edema.
TLDR
Two dissimilar diuretic agents were studied and it was found that when both agents were administered, significantly greater reductions in pressure were obtained and pressure reductions were maintained for longer periods.
The effect of furosemide on sodium-22 uptake into cerebrospinal fluid and brain
TLDR
It is suggested that the decrease in sodium-22 uptake into CSF and brain in the furosemide-treated animals may be caused by inhibition of active sodium transport in the choroid plexus.
The effect of acetazolamide and furosemide on cerebrospinal fluid production and choroid plexus carbonic anhydrase activity.
TLDR
In vitro studies showed that acetazolamide is about 100 times as potent as furosemide in the inhibition of carbonic anhydrase of the choroid plexus, and it may be possible to reduce CSF flow more than the approximately 50% that can be accomplished with the individual therapeutic agents presently in use.
Brain electrolytes and fluid metabolism
This volume, by a clinical neurologist and a neurochemist, provides an up-to-date review of current knowledge concerning fluid and electrolytes in the nervous system. This work cuts across several…
Effect of furosemide on experimental traumatic cerebral edema.
TLDR
Analysis of data from individual brain sections of furosemide-treated animals suggested a reduction in the spread of edema fluid 48 hours after head injury, significantly less than that found in the untreated groups.
Furosemide effect on isolated perfused tubules.
TLDR
The principal renal action of this drug is to inhibit active Cl transport in the thick ascending limb of Henle's loop with resultant decrease in net NaCl absorption and electrical PD.
Studies on the Mechanisms of Action of Steroids in Traumatized Brain
TLDR
Dexamethasone appears to have little, if any, generalized effect on the electrolyte metabolism of traumatized brain, and carbonic anhydrase is not involved in the sodium fluxes studied under experimental conditions.
Brain electrolytes and cortical impedance.
TLDR
Findings support the thesis that the compartment of the tissue containing the bulk of the chloride and sodium ions has a special significance for the cortical impedance.
PHYSIOLOGIC AND CLINICAL OBSERVATIONS ON FUROSEMIDE AND ETHACRYNIC ACID *
TLDR
The physiologic and clinical observations which describe the unique characteristics of the two new diuretic agents ethacrynic acid and furosemide are reviewed to provide more information about the nature and sites of renal tubular sodium transport mechanisms.
...
1
2
...