Korean J Neurotrauma.
2023 Jun;19(2):162-176. 10.13004/kjnt.2023.19.e25.
Optimizing Mannitol Use in Managing Increased Intracranial Pressure: A Comprehensive Review of Recent Research and Clinical Experiences
- Affiliations
-
- 1Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 2Department of Neurosurgery, Chungnam National University Hospital, Daejeon, Korea
- 3Department of Neurosurgery, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
- 4Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Korea
- 5Division of Neurotrauma & Neurocritical Care Medicine, Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 6Department of Critical Care Medicine, Kangbuk Samsung Hospital, Seoul, Korea
- 7Department of Critical Care Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
- 8Department of Neurosurgery and Neurology, Seoul National University Bundang Hospital, Seongnam, Korea
- 9Department of Neurosurgery, Yeungnam University Medical Center, Daegu, Korea
- 10Gachon University Gil Hospital Regional Trauma Center, Incheon, Korea
- 11Department of Neurosurgery, Gangnam Severance Hospital, Seoul, Korea
- 12Department of Neurosurgery, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea
- KMID: 2552612
- DOI: http://doi.org/10.13004/kjnt.2023.19.e25
Abstract
- Mannitol, derived from mannose sugar, is crucial in treating patients with elevated intracranial pressure (ICP). Its dehydrating properties at the cellular and tissue levels increase plasma osmotic pressure, which is studied for its potential to reduce ICP through osmotic diuresis. While clinical guidelines support mannitol use in these cases, the best approach for its application continues to be debated. Important aspects needing further investigation include: 1) bolus administration versus continuous infusion, 2) ICP-based dosing versus scheduled bolus, 3) identifying the optimal infusion rate, 4) determining the appropriate dosage, 5) establishing fluid replacement plans for urinary loss, and 6) selecting monitoring techniques and thresholds to assess effectiveness and ensure safety. Due to the lack of adequate high-quality prospective research data, a comprehensive review of recent studies and clinical trials is crucial. This assessment aims to bridge the knowledge gap, improve understanding of effective mannitol use in elevated ICP patients, and provide insights for future research. In conclusion, this review aspires to contribute to the ongoing discourse on mannitol application. By integrating the latest findings, this review will offer valuable insights into the function of mannitol in decreasing ICP, thereby informing better therapeutic approaches and enhancing patient outcomes.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Effects of Mannitol on Serum Osmolarity and Electrolytes in Neurosurgical Patients
- Hyperosmolar therapy for regulation of cerebral edema and intracranial pressure
- A Comparison of the Cerebral and Hemodynamic Effects of Mannitol and Hypertonic Saline in a Rabbit Model of Brain Injury
- Effects of the Selective Management for Increased Intracranial Pressure with Obstruction of Internal Carotid Artery in Rabbits
- Clinical Study on Mannitol Infusion on the Increased Intracranial Pressure Patients
