Swelling of your brain will cause elevated intracranial pressures. Imagine this. Your skull is an enclosed space. We’ve got limited room for a ruptured blood vessel. Theres comes a point where theres too much pressure, and blood will go to places it shouldnt. Thats herniation. To prevent this from happening, we’ve got a couple pharmacologic options. Mannitol and HTS. Mannitol relieves ICPs by osmotic diuresis. The oncotic pressure pulls water from your brain. Watch out for hypotension and volume status. Hypertonic saline creates a concentration gradient to pull water from the brain, pretty much dehydrating it. Its a hypertonic solution, follow your hospitals policy on peripheral lines. Check that sodium too, they might get too salty. No difference in mortality between these two, but meta analysis show hypertonic saline reduces intracerebral pressure quicker and achieves greater cerebral perfusion. For more PHARMFAX in the drug bank, tag a salty friend in the comments below.
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