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They observed changes to the convexity of cat's brain upon IV injection, specifically, they noted that Hypertonic Saline IV injection resulted in maximum shrinkage of the brain in 15-30 mins, while administration of hypotonic solutions resulted in protrusion and rupture of the brain tissue.
Hypertonic saline and mannitol are the main osmotic agents in use, while loop diuretics can aid in the removal of the excess fluid pulled out of the brain. [ 1 ] [ 3 ] [ 7 ] [ 43 ] Hypertonic saline is a highly concentrated solution of sodium chloride in water and is administered intravenously . [ 3 ]
A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity ranging from mild traumatic brain injury (mTBI/concussion) to severe traumatic brain injury. [ 5 ]
Saline solution for irrigation. Normal saline (NSS, NS or N/S) is the commonly used phrase for a solution of 0.90% w/v of NaCl, 308 mOsm/L or 9.0 g per liter. Less commonly, this solution is referred to as physiological saline or isotonic saline (because it is approximately isotonic to blood serum, which makes it a physiologically normal solution).
If there is an intact blood–brain barrier, osmotherapy (mannitol or hypertonic saline) may be used to decrease ICP. [33] It is unclear whether mannitol or hypertonic saline is superior, or if they improve outcomes. [34] [35] Struggling, restlessness, and seizures can increase metabolic demands and oxygen consumption, as well as increasing ...
While mannitol injection is the mainstay for treating high pressure in the skull after a bad brain injury, it is no better than hypertonic saline as a first-line treatment. In treatment-resistant cases, hypertonic saline works better. [17]
Central pontine myelinolysis; Other names: Osmotic demyelination syndrome, central pontine demyelination: Axial fat-saturated T2-weighted image showing hyperintensity in the pons with sparing of the peripheral fibers, the patient was an alcoholic admitted with a serum Na of 101 treated with hypertonic saline, he was left with quadriparesis, dysarthria, and altered mental status
In such occasions, mannitol (osmotic diuretic) or hypertonic saline are given to draw fluid out of the edematous cerebrum to minimise secondary injury. Hypertonic saline is better than mannitol, as mannitol being a diuretic will decrease the mean arterial pressure and since cerebral perfusion is mean arterial pressure minus intracranial ...
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