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Clinical & Experimental Ophthalmology Apr 2020
Topics: Anterior Chamber; Glaucoma; Humans; Intraocular Pressure; Mannitol
PubMed: 31804762
DOI: 10.1111/ceo.13695 -
Journal of Bacteriology Mar 1946
Topics: Dysentery, Bacillary; Humans; Mannitol; Shigella
PubMed: 21018707
DOI: 10.1128/JB.51.3.317-325.1946 -
Wisconsin Medical Journal May 1985
Topics: Acute Kidney Injury; Adult; Brain Edema; Female; Humans; Mannitol
PubMed: 3925648
DOI: No ID Found -
Acta Anaesthesiologica 1965
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Journal of Neurosurgery Feb 1978There is little information as to the optimal use of mannitol. To determine the dose-response relationship, the osmotic gradient required, and the time course of...
There is little information as to the optimal use of mannitol. To determine the dose-response relationship, the osmotic gradient required, and the time course of intracranial pressure (ICP) reduction produced by mannitol, eight patients with acute head injury were studied in whom ICP was monitored with a ventriculostomy and found to be elevated. Ventilation was controlled to a pCO2 of 25 +/- 3 mm Hg and all were paralyzed with Pavulon. None had received barbiturates. Before mannitol administration the intracranial volume-pressure response was determined. Mannitol was administered as a bolus of 0.25 gm/kg, 0.5 gm/kg, and in six patients, 1 gm/kg, separated by at least 8 hours. In all patients the ICP reduction with 0.25 gm/kg (41.3 +/- 10.2 mm Hg leads to 16.4 +/- 5.6, p less than 0.01) was equivalent to that achieved with the larger doses. Serum osmolality rises of 10 mOsm or more were associated with a reduction in ICP. Much smaller doses than those previously recommended were effective in reducing the ICP acutely, although at 5 hours there was a trend toward persistent reduction when the larger dose is used. This trend was small and indicates that smaller and more frequent doses are as effective in reducing the ICP while avoiding the risk of osmotic disequilibrium and severe dehydration.
Topics: Brain Injuries; Humans; Intracranial Pressure; Mannitol; Osmolar Concentration
PubMed: 624964
DOI: 10.3171/jns.1978.48.2.0169 -
Journal of Postgraduate Medicine Jan 1978
Topics: Cataract Extraction; Humans; Mannitol
PubMed: 731610
DOI: No ID Found -
Biochimica Et Biophysica Acta May 1959
Topics: Carbohydrate Metabolism; Fungi; Inactivation, Metabolic; Mannitol
PubMed: 13651220
DOI: 10.1016/0006-3002(59)90534-7 -
British Medical Journal Dec 1972
Topics: Animals; Dogs; Isotonic Solutions; Lithium; Mannitol
PubMed: 4642806
DOI: 10.1136/bmj.4.5839.550-b -
Scientific Reports May 2017An optimum carrier rugosity is essential to achieve a satisfying drug deposition efficiency for the carrier based dry powder inhalation (DPI). Therefore, a non-organic...
An optimum carrier rugosity is essential to achieve a satisfying drug deposition efficiency for the carrier based dry powder inhalation (DPI). Therefore, a non-organic spray drying technique was firstly used to prepare nanoporous mannitol with small asperities to enhance the DPI aerosolization performance. Ammonium carbonate was used as a pore-forming agent since it decomposed with volatile during preparation. It was found that only the porous structure, and hence the specific surface area and carrier density were changed at different ammonium carbonate concentration. Furthermore, the carrier density was used as an indication of porosity to correlate with drug aerosolization. A good correlation between the carrier density and fine particle fraction (FPF) (r = 0.9579) was established, suggesting that the deposition efficiency increased with the decreased carrier density. Nanoporous mannitol with a mean pore size of about 6 nm exhibited 0.24-fold carrier density while 2.16-fold FPF value of the non-porous mannitol. The enhanced deposition efficiency was further confirmed from the pharmacokinetic studies since the nanoporous mannitol exhibited a significantly higher AUC value than the non-porous mannitol and commercial product Pulmicort. Therefore, surface modification by preparing nanoporous carrier through non-organic spray drying showed to be a facile approach to enhance the DPI aerosolization performance.
Topics: Animals; Budesonide; Drug Carriers; Male; Mannitol; Nanoparticles; Particle Size; Porosity; Rats; Rats, Sprague-Dawley; Solvents
PubMed: 28462948
DOI: 10.1038/srep46517 -
Journal of Neurosurgery Feb 2022Previous studies have suggested the use of 1.0 g/kg of 20% mannitol at the time of skin incision during neurosurgery in order to improve brain relaxation. However, the... (Randomized Controlled Trial)
Randomized Controlled Trial
Comparison of 1.0 g/kg of 20% mannitol initiated at different time points and effects on brain relaxation in patients with midline shift undergoing supratentorial tumor resection: a randomized controlled trial.
OBJECTIVE
Previous studies have suggested the use of 1.0 g/kg of 20% mannitol at the time of skin incision during neurosurgery in order to improve brain relaxation. However, the incidence of brain swelling upon dural opening is still high with this dose. In the present study, the authors sought to determine a better timing for mannitol infusion.
METHODS
One hundred patients with midline shift who were undergoing elective supratentorial tumor resection were randomly assigned to receive early (immediately after anesthesia induction) or routine (at the time of skin incision) administration of 1.0 g/kg body weight of 20% mannitol. The primary outcome was the 4-point brain relaxation score (BRS) immediately after dural opening (1, perfectly relaxed; 2, satisfactorily relaxed; 3, firm brain; and 4, bulging brain). The secondary outcomes included subdural intracranial pressure (ICP) measured immediately before dural opening; serum osmolality and osmole gap (OG) measured immediately before mannitol infusion (T0) and at the time of dural opening (TD); changes in serum electrolytes, lactate, and hemodynamic parameters at T0 and 30, 60, 90, and 120 minutes thereafter; and fluid balance at TD.
RESULTS
The time from the start of mannitol administration to dural opening was significantly longer in the early administration group than in the routine administration group (median 66 [IQR 55-75] vs 40 [IQR 38-45] minutes, p < 0.001). The BRS (score 1/2/3/4, n = 14/26/9/1 vs 3/25/18/4, p = 0.001) was better and the subdural ICP (median 5 [IQR 3-6] vs 7 [IQR 5-10] mm Hg, p < 0.001) was significantly lower in the early administration group than in the routine administration group. Serum osmolality and OG increased significantly at TD compared to levels at T0 in both groups (all p < 0.001). Intergroup comparison showed that serum osmolality and OG at TD were significantly higher in the routine administration group (p < 0.001 and = 0.002, respectively). Patients who had received early administration of mannitol had more urine output (p = 0.001) and less positive fluid balance (p < 0.001) at TD. Hemodynamic parameters, serum lactate concentrations, and incidences of electrolyte disturbances were comparable between the two groups.
CONCLUSIONS
Prolonging the time interval between the start of mannitol infusion and dural incision from approximately 40 to 66 minutes can improve brain relaxation and decrease subdural ICP in elective supratentorial tumor resection.
Topics: Brain; Craniotomy; Humans; Intracranial Pressure; Lactic Acid; Mannitol; Prospective Studies; Supratentorial Neoplasms
PubMed: 34359042
DOI: 10.3171/2021.1.JNS204001