The Effect Of Intracranial Pressure On Adults With Traumatic Brain Injury Essay

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Title Use of mannitol versus hypertonic saline in the reduction of intracranial pressure in adults with traumatic brain injury. Introduction: The use of mannitol (MTL) and hypertonic saline (HTS) are the main medical management for elevated intracranial pressure (ICP) in traumatic brain injury (TBI) (Marko, 2012). The use of hyperosmotic agents to reduce brain volumes has been known since 1919 (Ropper, 2012). HTS is gaining in popularity over the last few decades (Colton, et al., 2016), but MTL remains the gold standard in the treatment of ICP in the setting of post traumatic events and has been used since 1980s, it is used in most trauma protocols for emergency medicine (Marko, 2012). According to the new Evidence Based Medicine, HTS might be a good replacement to MTL with less side effects and better outcome in the long term (Hays, et al., 2011) (Marko, 2012). The two agents used the same mechanism of action by increasing the osmolality of the blood and both required an intact blood brain barrier (BBB) (Sakellaridis, et al., 2011) (Ropper, 2012). HTS would be in general more effective and superior to MTL for the treatment of ICP (Kamel, Navi, Nakagawa, Hemphil, & Ko, 2011). Raised ICP is recognised as one of the major causes of mortality as well as poor neurologic outcomes (Fink, 2012). It accounts for about half of all deaths associated with TBI (Jagannatha, Sriganesh, Devi, & Rao, 2016). Increase ICP can be caused by TBI and multiple other causes (Fink, 2012).

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