Diuretic Therapy
Mannitol (0.25-1 gm / kg)
Increases serum osmolarity
Vasoconstriction (adenosine) / less effect if autoregulation is impaired and if CPP is < 70
Initial increase in blood volume, BP and ICP followed by decrease
Questionable mechanism of lowering ICP
- Rosner et al. (1987) Neurosurgery, 21(2)
Decreased systemic and cerebral blood volume (impairs sodium and water movement across blood brain barrier)
May have best affect in conjunction with mannitol
- Pollay et al. (1983) Journal of Neurosurgery, 59 ; Wilkinson (1983) Neurosurgery,12(4)