Hypertonic Saline (7.5%) versus Mannitol: A Comparison for Treatment of Acute Head Inju ries.

Hypertonic saline (7.5% NaCl) was compared with 20% mannitol for the treatment of increased intracranial pressure in an animal model. The hypertonic saline solution was equally effective in treating an elevated intracranial pressure caused by a space-occupying lesion as the 20% mannitol. Hypertonic saline has the additional advantage of rapid cardiovascular resuscitation of associated hemorrhagic shock with small infusion volumes. Studies have demonstrated that resuscitation of hemorrhagic shock with Ringer's lactate solutions results in a marked elevation of intracranial pressure compared with hypertonic saline solutions (Crit. Care Med. 13:407, 85; Ann. Surg. 204:686, 86). Hypertonic saline solutions may be valuable in the resuscitation of head injury patients with hypotension by reducing secondary injuries to the brain by maintaining adequate cerebral perfusion pressures. J. Trauma 35:344, Sept. 93.

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