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Sunday, June 5, 2016

HYPERTONIC SALINE VS MANNITOL FOR MANAGEMENT OF ACUTELY RAISED ICP

๐Ÿ”ณ Like mannitol, hypertonic saline
๐Ÿ”ปcreate an oncotic pressure difference that mobilises water across the blood–brain barrier through osmosis. 
๐Ÿ”ปshrinks erythrocytes and makes them more deformable 
๐Ÿ”ปincreases the calibre of the microcirculation by dehydrating vascular endothelium

๐Ÿ”ณ Advantages of Hypertonic Saline over mannitol:
๐Ÿ”ปless haemodynamic instability
๐Ÿ”ปless damage to the kidneys 
๐Ÿ”ปeasier therapeutic monitoring through tracking serum sodium concentration. 
๐Ÿ”ปless inclined to produce the late rise in ICP sometimes found with mannitol when it is deposited in the brain parenchyma.

๐Ÿ”ณ But no difference in survival between the two agents has been demonstrated.

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