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The Use of Mannitol and Hypertonic Saline Therapies in Patients with Elevated Intracranial Pressure: A Review of the Evidence.

Abstract Patients with increased intracranial pressure generally require pharmacologic therapies and often more definitive treatments, such as surgical intervention. The overall goal of these interventions is to maintain or re-establish adequate cerebral blood flow and prevent herniation. Regardless of the cause of increased intracranial pressure, osmotherapy is considered the mainstay of medical therapy, and should be administered as soon as possible. This article reviews the history of hyperosmolar and hypertonic therapies, the Monro-Kellie hypothesis, and types of cerebral edema. Pharmacologic properties, clinical applications, complications, recommended monitoring during therapy, and risks versus benefits are also discussed.
PMID
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Authors

Mayor MeshTerms
Keywords

Elevated ICP

Hyperosmolar therapy

Hypertonic saline

Intracranial hypertension

Mannitol

Journal Title the nursing clinics of north america
Publication Year Start




PMID- 28478873
OWN - NLM
STAT- MEDLINE
DA  - 20170508
DCOM- 20170515
LR  - 20170515
IS  - 1558-1357 (Electronic)
IS  - 0029-6465 (Linking)
VI  - 52
IP  - 2
DP  - 2017 Jun
TI  - The Use of Mannitol and Hypertonic Saline Therapies in Patients with Elevated
      Intracranial Pressure: A Review of the Evidence.
PG  - 249-260
LID - S0029-6465(17)30013-0 [pii]
LID - 10.1016/j.cnur.2017.01.002 [doi]
AB  - Patients with increased intracranial pressure generally require pharmacologic
      therapies and often more definitive treatments, such as surgical intervention.
      The overall goal of these interventions is to maintain or re-establish adequate
      cerebral blood flow and prevent herniation. Regardless of the cause of increased 
      intracranial pressure, osmotherapy is considered the mainstay of medical therapy,
      and should be administered as soon as possible. This article reviews the history 
      of hyperosmolar and hypertonic therapies, the Monro-Kellie hypothesis, and types 
      of cerebral edema. Pharmacologic properties, clinical applications,
      complications, recommended monitoring during therapy, and risks versus benefits
      are also discussed.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Witherspoon, Briana
AU  - Witherspoon B
AD  - Neuroscience, Department of Anesthesiology, Vanderbilt University Medical Center,
      1161 21st Avenue South, AA-1214 MCN, Nashville, TN 37232, USA. Electronic
      address: [email protected]
FAU - Ashby, Nathan E
AU  - Ashby NE
AD  - Department of Anesthesiology, Division of Critical Care, Vanderbilt University
      Medical Center, 1211 21st Avenue South, MAB 526, Nashville, TN 37212, USA.
LA  - eng
PT  - Historical Article
PT  - Journal Article
PT  - Review
DEP - 20170407
PL  - United States
TA  - Nurs Clin North Am
JT  - The Nursing clinics of North America
JID - 0042033
RN  - 0 (Saline Solution, Hypertonic)
RN  - 3OWL53L36A (Mannitol)
SB  - AIM
SB  - IM
SB  - N
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Fluid Therapy/*history/*methods
MH  - History, 20th Century
MH  - History, 21st Century
MH  - Humans
MH  - Intracranial Hypertension/*drug therapy
MH  - Male
MH  - Mannitol/*history/*therapeutic use
MH  - Middle Aged
MH  - Saline Solution, Hypertonic/*history/*therapeutic use
OTO - NOTNLM
OT  - *Elevated ICP
OT  - *Hyperosmolar therapy
OT  - *Hypertonic saline
OT  - *Intracranial hypertension
OT  - *Mannitol
EDAT- 2017/05/10 06:00
MHDA- 2017/05/16 06:00
CRDT- 2017/05/09 06:00
AID - S0029-6465(17)30013-0 [pii]
AID - 10.1016/j.cnur.2017.01.002 [doi]
PST - ppublish
SO  - Nurs Clin North Am. 2017 Jun;52(2):249-260. doi: 10.1016/j.cnur.2017.01.002. Epub
      2017 Apr 7.

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