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- W4285258235 abstract "Intravenous hyperosmolar fluids have been used for the clinical management of intracranial hypertension. The most suitable agent depends on the patient’s age, comorbidities, and clinical status. Since hypertonic saline causes an intravascular volume expansion, it can be advantageous for hypovolemic patients. Still, it should be used with caution in patients with cardiac heart failure, in whom it may precipitate acute pulmonary edema. In contrast, mannitol induces a strong diuretic response that can lead to a severe blood volume depletion that should be promptly treated to avoid complications. Other concerns related to its use are the rebound phenomenon and a potential risk of hematoma expansion in patients with intracranial hemorrhages. The main concern in patients receiving hypertonic saline is hypernatremia. It poses a theoretical risk of osmotic demyelination when serum sodium levels rise quickly, especially in hyponatremic patients. Both agents can cause renal injuries but through distinct mechanisms. Whereas high serum mannitol concentrations can lead to osmotic nephrosis, renal function impairment associated with hypertonic saline infusion seems to be mediated by hypernatremia and hyperchloremia. Further research is warranted to determine the optimal agent and their best means of administration (boluses vs. continuous infusions) for each neurocritical condition. More extensive clinical trials are needed to address long-term outcomes, adverse events, and quality of life with both agents." @default.
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- W4285258235 date "2022-01-01" @default.
- W4285258235 modified "2023-09-29" @default.
- W4285258235 title "Hyperosmolar Fluids" @default.
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- W4285258235 doi "https://doi.org/10.1007/978-981-19-0954-2_5" @default.
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