What is the difference between mannitol and lasix

Procedures alert. Receive exclusive offers and updates from Oxford Academic. Related articles in Web of Science Google Scholar. Related articles in PubMed Causal relationship between slow waves of arterial, intracranial pressures and blood velocity in brain. Comparison of non-invasive Staphylococcus aureus sampling methods on lesional skin in patients with atopic dermatitis. Is mannitol combined with furosemide a new treatment for refractory lymphedema? A case report. Citing articles via Web of Science A Retrospective Analysis of Patients.

Looking for your next opportunity? Physician-Scientist Faculty Position. Infectious Disease Physician. Senior Clinician. View all jobs. Neurosurgery 4: 48—52, Measurement of oedema clearance into ventricular CSF. Acta Neurochir 1—13, Wise BL : Osmotic reduction of brain bulk.

J Neurosurg , Letter. J Neurosurg 19 : — , Wise BL, Chater N: The value of hypertonic mannitol solution in decreasing brain mass and lowering cerebrospinal-fluid pressure. Sign in Sign up.

Advanced Search Help. Effect of mannitol and furosemide on blood-brain osmotic gradient and intracranial pressure. Michael Pollay M. Alex Roberts Ph. Alan Stevens B. Restricted access. Click here for subscription options. Buy Online Only Now. Your current browser may not support copying via this button.

Volume Issue 6 Dec in Journal of Neurosurgery. Article Information. Box , Oklahoma City, Oklahoma Keywords: blood-brain barrier ; osmotic gradient ; diuretic effect ; intracranial pressure ; osmotic and loop diuretics Page Count: 6. Export References. New York: McGraw-Hill, , pp — false. Exp Brain Res —, false. Neurology —, false. Anesthesiology 28—30, Cottrell JE , Robustelli A , Post K , et al : Furosemide- and mannitol-induced changes in intracranial pressure and serum osmolality and electrolytes.

Background: Mannitol and furosemide are used to reduce increased intracranial pressure ICP and to reduce brain bulk during neurosurgery. One mechanism by which these changes might occur is via a reduction in brain water content. Although mannitol and furosemide are commonly used in combination, there has been no formal evaluation of the interactive effects of these two drugs on brain water.

The hole was located midway between the coronal and lambdoid sutures and was centered approximately 2. The dura remained intact. The hub of a standard gauge blunt needle Becton, Dickinson and Co. The hub was then fixed in place with cyanoacrylate glue. When preparation was complete, the hub was filled with normal saline and attached to the outlet port of a fluid percussion unit manufactured by the Department of Bioengineering, Virginia Commonwealth University, Richmond, VA.

With the animal still prone, a 2. The pressure generated during the pulse was monitored with an oscilloscope; animals were excluded if peak pressures were inadequate. Anesthesia, mechanical ventilation, and normothermia were maintained thereafter.

Catheters were intermittently flushed with small volumes of heparinized saline, and any blood withdrawn was replaced with an equal volume of saline. No other fluids were infused. Two and one-half hours after injury, animals were assigned in random sequence to one of nine groups. Arterial blood was sampled for the measurement of arterial oxygen tension, arterial carbon dioxide tension, pH, and plasma osmolality freezing point depression, Advanced Instruments model 3MO; Needham Heights, MA.

Beginning 2. The groups were as follows group sizes can be found in table 1 :. Control: Animals were prepared as above, including placement of the fluid percussion cannula. No fluid percussion injury was performed, and no drug infusions were administered. Impact only: Fluid percussion injury and ventilatory support were performed, but no drugs were infused. This resulted in the infusion of approximately 0.

This resulted in an infusion of approximately 0. All drug infusions were complete by 3 h after injury. One hour later, arterial blood gases, pH, and plasma osmolality were again measured. The animals were killed with an overdose of halothane and decapitated, and the brain was rapidly removed.

The cerebellum and brain stem were removed. The cerebral hemispheres were then separated, placed into preweighed glass vials, weighed to the nearest 0. For the purpose of maintaining statistical power when comparing the effects of mannitol, furosemide, and their combinations, only selected intergroup comparisons were performed. The primary purpose of the study was to compare the effects on brain water content of high doses of mannitol and furosemide, alone and in combination. First, to verify that impact resulted in an increase in water content, water content of both hemispheres for control and impact-only groups were compared with a repeated-measures analysis of variance, with left and right hemispheric water contents as the repeated measure; a post hoc paired t test was used to examine left versus right hemispheric water content.

Second, a two-way repeated-measures analysis of variance with left vs. Differences in MAP, arterial blood gases, and osmolality were examined using two-way repeated-measures analysis of variance with group as the between-group factor and values measured before and after drug administration as the repeated measure.

Subsequently, a one-way analysis of variance was used to examine intergroup differences in left hemispheric water content. A total of rats were subjected to fluid percussion injury or served as controls. Twelve injured animals died before the end of the experiment. Protocol errors or errors in tissue handling or blood sampling occurred in 5 animals, leaving 91 animals for which osmolality and brain water data were available.

Blood pressure, blood gases, osmolality, and hemispheric brain water content data for all groups are presented in table 1. Injury resulted in an increase in water content in both hemispheres control vs.

There were no differences in pH, arterial blood gas values, plasma osmolality, or MAP before drug treatment in the four selected groups. Statistically significant reductions in MAP and pH both vs. Furosemide alone did not alter plasma osmolality or brain water content vs. There were, however, no differences in osmolality or brain water content between these latter two groups.

These results are summarized in figure 1. However, there was no difference between mannitol and mannitol-plus-furosemide groups in either water content or osmolality.

The effects of hypertonic solutions on brain volume and ICP in animals were first described in the early part of the 20th century. The effects of furosemide on ICP were first reported in the late s.

Some experiments have suggested an effect of furosemide on brain water content, whereas others have not demonstrated such changes. Therapy with a combination of mannitol and furosemide was first described by Harbaugh et al. Four subsequent animal studies have also examined the impact of such a combination on ICP.

Nevertheless, the combination of mannitol and furosemide was reported to produce a greater increase in serum osmolality than mannitol alone, 38 and several studies showed that the combination resulted in a longer lasting reduction in ICP than did mannitol alone.

The uncertainty raised by these studies, along with the clinical use of the combination of mannitol and furosemide, led to our earlier study. To further understand the action of these drugs, we extended our earlier study using animals that had been subjected to a fluid percussion brain injury.