Treatment of elevated intracranial pressure by infusions of 10% saline in severely head injured patients
Schatzmann, C.; Heissler, H.E.; König, K.; Klinge-Xhemajli, P.; Rickels, E.; Mühling, M.; Börschel, M.; Samii, M.
Acta Neurochirurgica. Supplement 71: 31-33
1998
ISSN/ISBN: 0065-1419 PMID: 9779135 Document Number: 484357
The management of intracranial pressure (ICP) is a factor in outcome of patients with head trauma. However, recent studies have revealed that the current strategies, which have been applied to control ICP for adequate cerebral perfusion, are unsatisfactory. Against this background, the efficacy of short-term infusions of hypertonic saline on ICP was investigated. In severely head injured (SHI) patients, hypertonic saline (100 ml 10% NaCl) was administered when standard agents (mannitol, sorbitol, THAM) failed in reducing ICP. To evaluate the pressure reduction after saline infusions the resulting ICP relaxations were analysed statistically in respect to the parameters amplitude, duration and dynamic behaviour of the ICP responses. In 42 randomized relaxations, the relative ICP decrease was 43% after infusion. In the individual cases the temporal course of the parameters amplitude and decline interval depict a tendency toward lower and higher values, respectively, under conditions of a generally increasing ICP. As expected, the infusion of hypertonic saline reduces ICP in patients suffering from SHI. The pressure drop, duration and dynamic behaviour are suspected to depend both on the pressure level to reduce and concomitant medications.