Abstract

RATIONALE USE OF MANNITOL AND GLYCEROL IN HEAD INJURY PATIENTS -A COMPARATIVE STUDY AND REVIEW OF LITERATURE

Dr. Sanjay Sharma*, Piyush Kumar Saini, Dr. Namita Sharma

ABSTRACT

Traumatic brain injury is one of the major causes of increased intracranial pressure (ICP), due to post head injury cerebral oedema and deterioration of condition and death in patients. Cerebral oedema is a common cause of unconsciousness and ensues post Cerebrovascular accidents, head injury, convulsive disorder and encephalitis either due to infection or toxin accumulation which occur due to failure of energy dependant Sodium Potassium ATPase pump resulting in accumulation of sodium and water in addition to release of free radicals and proteases due to activation of microglial cells from disrupted cell membrane and capillaries. The commonly used drugs for reduction of cerebral oedema are mannitol, glycerol and hypertonic saline. Mannitol is commonly used dehydrant for treatment of traumatic brain injury, but when it is used irrationally or its excessive use leads to ineffectiveness and adverse effects, leading to rebound phenomena. The aim of the study is rational use of mannitol in head injury patients and comparative assessment of combination use of Mannitol 10% with Glycerol 10% versus Mannitol 20% in cerebral oedema of traumatic origin.

Keywords: Cerebral oedema, Combination therapy, Electrolyte imbalance, Renal failure, Rebound phenomena.