A Comparison of the Cerebral and Hemodynamic Effects of Mannitol and Hypertonic Saline in a Rabbit Model of Brain Injury / 대한마취과학회지

ABSTRACT

There has recently been an increased interest in the use of hypertonic saline for the fluid resuscitation of trauma victims and to control intracranial hypertension. In this study, the cerebral and hemodynamic effects of a 3.2% hypertonic saline solution were compared with those of either a 0.9% saline or 20% mannitol solution in a rabbit model of brain injury. Forty-five minutes following the creation of a left hemispheric cryogenic brain lesion, equal volumes of hypertonic saline, 0.9% saline, or mannitol were infused over a 5 minute period. Monitored variables over the ensuing 120 minutes included mean arterial pressure, central venous pressure, intracranial pressure, hematocrit and serum osmolality. Upon conclusion of the two hour study period, regional cortical water content was determined by the specific gravity method. There were no significant differences in mean arterial pressure between the three groups at any point during the experiment. Plasma osmolality was signifieantly increased by 10-11 mOsm/kg in the mannitol and hypertonic groups. The infusion of either mannitol or hypertonic saline produced a transient decrease in intracranial pressure lasting approximately 60 minutes, whereas animals in the saline group demonstrated a continual increase in intracranial pressure. The lesioned hemisphere demonstrated a significantly greater water content than the non-lesioned hemisphere. There was no difference in regional cortical water content at any sampling site between the various groups.