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

Scheller, Mark S.; Zornow, Mark H.; Seok, Yong

doi:10.1097/00008506-199112000-00009

Cited by 27 publications

(11 citation statements)

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“…Finally, in the only other equivolume, equiosmolar comparison, Scheller et al 13 demonstrated that 3.2% HS and 20% mannitol decreased ICP for 60-90 min and reduced water content in the contralateral noninjured cerebral hemisphere after 2 h with equal efficacy. Although our study also demonstrated the dehydrating potency of HS, it was not as great as the effect of mannitol throughout the entire 5-h observation period.…”

Section: Discussionmentioning

confidence: 97%

“…In a model of acute cryogenic brain injury in rabbits, Scheller et al reported that equiosmolar solutions of HS (3.2%) and mannitol (20%) reduced ICP and brain water content equally well when infused at equal volumes. 13 A recent clinical study using equivolume, equiosmolar solutions of 20% mannitol and 3% HS revealed no difference in brain relaxation as judged by the surgeon's subjective assessment. 14 However, in uninjured animals, no fundamental data exist on reduction of brain water by these agents while maintaining parity with respect to administered volume and solute load.…”

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confidence: 96%

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Comparison of Equivolume, Equiosmolar Solutions of Mannitol and Hypertonic Saline with or without Furosemide on Brain Water Content in Normal Rats

et al. 2013

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Section: Discussionmentioning

confidence: 97%

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confidence: 96%

Comparison of Equivolume, Equiosmolar Solutions of Mannitol and Hypertonic Saline with or without Furosemide on Brain Water Content in Normal Rats

et al. 2013

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“…HTS solutions reduced brain edema in rabbits (Scheller et al, 1991; Zornow et al, 1990). These studies suggest there is no difference between the reduction in edema between HTS and mannitol, an osmotic diuretic agent used to treat ICP.…”

Section: Introductionmentioning

confidence: 99%

The effects of hypertonic saline and nicotinamide on sensorimotor and cognitive function following cortical contusion injury in the rat

Quigley¹,

Tan

Hoane

2009

Brain Research

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Hypertonic saline (HTS) is an accepted treatment for traumatic brain injury (TBI). However, the behavioral and cognitive consequences following HTS administration have not thoroughly been examined. Recent preclinical evidence has suggested that nicotinamide (NAM) is beneficial for recovery of function following TBI. The current study compared the behavioral and cognitive consequences of HTS and NAM as competitive therapeutic agents for the treatment of TBI. Following controlled cortical impact (CCI), bolus administrations of NAM (500 mg/kg), 7.5% HTS, or 0.9% saline vehicle (1.0 mL/kg) were given at 2, 24, and 48 hrs post-CCI. Behavioral results revealed that animals treated with NAM and HTS showed significant improvements in beam walk and locomotor placing compared to the Vehicle group. The Morris water maze (MWM) retrograde amnesia test was conducted on day 12 post-CCI and showed that all groups had significant retention of memory compared to injured, Vehicle-treated animals. Working memory was also assessed on days 18-20 using the MWM. The NAM and Vehicle groups quickly acquired the task; however, HTS animals showed no acquisition of this task. Histological examinations revealed that the HTS-treated animals lost significantly more cortical tissue than either the NAM or Vehicle-treated animals. HTS-treated animals showed a greater loss of hippocampal tissue compared to the other groups. In general, NAM showed a faster rate of recovery than HTS without this associated tissue loss. The results of this study reiterate the strengths of NAM following injury and show concerns with bolus administrations of HTS due to the differential effects on cognitive performance and apparent tissue loss.

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“…Its advantages over mannitol include its ability to increase perfusion while concomitantly decreasing ICP [10,16,[53][54][55][56][57][58][59] and a longer duration of action [21,66,84] making it potentially more effective than mannitol in treating cerebral edema and increased ICP.…”

Section: Hypertonic Salinementioning

confidence: 99%

The use of Hypertonic Saline in the Treatment of Post-Traumatic Cerebral Edema: A Review

Catrambone

Prestigiacomo

et al. 2007

Eur J Trauma Emerg Surg

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Effective methods for treating cerebral edema have recently become a matter of both extensive research and significant debate within the neurosurgery and trauma surgery communities. The pathophysiologic progression and outcome of different forms of cerebral edema associated with traumatic brain injury have yet to be fully elucidated. There are heterogeneous factors influencing the onset and progress of post-traumatic cerebral edema, including the magnitude and type of head injury, age, co-morbid conditions of the patient, the critical window for therapeutic intervention and the presence of secondary insults including hypoxia, hypotension, hypo/hyperthermia, degree of raised intracranial pressure (ICP), and disruption of blood brain barrier (BBB) integrity. Although numerous studies have been designed to improve our understanding of the etiology of post-traumatic cerebral edema, therapeutic interventions have traditionally been focused on minimizing secondary insults especially raised ICP and improving cerebral perfusion pressure. More recently, fluid resuscitation strategies using hyperosmolar agents such as pentastarch and hypertonic saline (HS) have achieved some success. HS treatment is of particular interest due to its apparent advantageous action over other types of hyper-osmotic solutions in both clinical and laboratory studies. In this review, we provide a summary of recent literature concerning the pathogenesis and mechanisms involved in the various types of cerebral edema, and the possible mechanisms of action of HS for the treatment cerebral edema.

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

Cited by 27 publications

References 0 publications

Comparison of Equivolume, Equiosmolar Solutions of Mannitol and Hypertonic Saline with or without Furosemide on Brain Water Content in Normal Rats

Comparison of Equivolume, Equiosmolar Solutions of Mannitol and Hypertonic Saline with or without Furosemide on Brain Water Content in Normal Rats

The effects of hypertonic saline and nicotinamide on sensorimotor and cognitive function following cortical contusion injury in the rat

The use of Hypertonic Saline in the Treatment of Post-Traumatic Cerebral Edema: A Review

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