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Osmotic agents for ICP control Susumu YAMASHITA 1 1Department of Emergency Medicine Tokuyama Central Hospital pp.856-859
Published Date 2017/10/1
DOI https://doi.org/10.11477/mf.3102200450
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Osmotic diuretics including mannitol and glycerol are widely used to control intracranial pressure (ICP) in Japan. A major adverse effect of osmotic diuretics is a rebound phenomenon (a paradoxical rise in ICP). In Japan, glycerol is more commonly used than mannitol based on the idea that the risk for rebound is higher with mannitol. In western countries, however, the use of mannitol is far more common, probably due to its pharmacological efficacy and the fact that there is no inferiority of mannitol compared with glycerol in terms of rebound. Hypertonic saline (HTS) is another osmotic agent used to control ICP. In Japan, the use of HTS is not yet common, but it remains promising since the beneficial effect on increased ICP lasts longer and rebound is less common with HTS than with mannitol. Although osmotic therapy is widely accepted for the management of ICP, no reliable data show that ICP-oriented care improves patient outcomes. To improve the outcomes of patients with increased ICP, hemodynamic parameters including cerebral perfusion pressure and cerebral blood flow should also be considered.


Copyright © 2017, MEDICAL SCIENCES INTERNATIONAL, LTD. All rights reserved.

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電子版ISSN 2186-7852 印刷版ISSN 1883-4833 メディカル・サイエンス・インターナショナル

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