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Query: UMLS:C0268318 (ICP)
 10,007 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors present their results regarding the use of a buffered solution of glycerol 30%-sodium ascorbate 20% (GLIAS) for the treatment of brain oedema and intracranial hypertension. GLIAS was perfused intravenously in 80 patients with several types of brain oedema. In every patients serum and urinary osmolarity, diuresis, main blood and urine parameters, and ICP were monitored. Following GLIAS infusion an increase in plasma osmolarity was observed, changing the average basal value plus 13.4% after 15 min., 10.5% after 30'. At the same time there was a reduction of ICP and improvement in cerebral compliance. In each case there was a decrease in intracranial hypertension and brain oedema without significant collateral effects.
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PMID:Brain oedema and intracranial hypertension treatment by GLIAS. 141 43

Cerebral blood flow was assessed as initial slope index by 133-Xenon inhalation in 36 patients with brain tumours subjected to osmotic dehydration. The following solutions were employed: I. 20% mannitol, II. 40% sorbitol, III. 10% glycerol. Parameters affecting blood rheologic properties as Hct, plasma viscosity, red blood cell aggregation and fluidity were simultaneously studied. CBF which was reduced in the oedematous hemisphere with brain tumour increased during infusion and thereafter by mannitol or sorbitol, respectively. The blood flow response to glycerol was more delayed, less intense, but maintained longer. Hct and plasma viscosity were significantly reduced by all osmotic agents, while red blood cell fluidity fell and aggregation rose under mannitol. It is concluded that sorbitol (40%) is superior for emergency treatment with high ICP, whereas glycerol seems to be preferable to improve cerebral blood flow in oedematous brain.
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PMID:Cerebral blood flow and rheologic alterations by hyperosmolar therapy in patients with brain oedema. 212 75

Nineteen hydrocephalic patients were studied to determine factors affecting cerebrospinal fluid (CSF) flow through shunts. This study was based on our previously reported method by which fluctuations in CSF flow through a shunt of from 0.01 ml min-1 to 1.93 ml min-1 were identified, each having its own rhythmic pattern. While CSF flow in a supine position was less than 0.01 ml min-1, head elevation to 60 degrees led to increases in CSF flow from 0.12 ml min-1 to 0.17 ml min-1. Sudden respiratory changes such as coughing also affected CSF flow. CSF flows were higher than average between 10 pm and 7 am, and changes in CSF flow were related to slight increases in ICP during REM sleep. There is no relationship between CSF flow in a shunt and daily fluid intake which varied from 27 ml kg-1 to 103 ml kg-1, and no significant changes in CSF flow resulting from rapid intravenous injection of Glycerol and Ringer's solution.
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PMID:Factors affecting cerebrospinal fluid flow in a shunt. 326 43

The continuous epidural registration of intracerebral pressure showed that the pronounced brain edema which develops during the 4th to 14th day of an intracerebral hemorrhage could lead to an increase in intracerebral pressure (ICP greater than 25 mmHg) requiring treatment. During the therapy extensive ICP crises (ICP greater than 35 mmHg), lasting for 1 to 3 days and only controllable through high doses of glycerol and sorbitol, developed. Glycerol (50 g orally) and sorbitol (50 g i.v.) lowered the pressure during this phase for approximately 3 h and 1.5 h respectively. These time intervals were in accordance with the changes in plasma osmolality through the administration of both substances. Due to its longer efficacy, glycerol provides an important supplement or alternative to sorbitol therapy, especially as the permitted maximum dosage would have to have been exceeded in a treatment consisting exclusively of sorbitol. The duration of the decrease in intracerebral pressure lasted longer during the remainder of the treatment in the case of both substances, being decisively dependent on the intracerebral pressure intensity. The relatively harmless epidural measurement of intracerebral pressure allowed an optimal control of the brain edema therapy as the dosage of the hyperosmolar substances could be given exactly in accordance with the intracerebral pressure intensity and subsequently varying efficacy.
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PMID:[Intracranial pressure-controlled treatment of brain edema with glycerin and sorbitol in intracerebral hemorrhage]. 356 10

After reviewing the literature, a personal series of 10 adult patients with cerebellar infarction diagnosed by CT scan is described. The clinical picture in young adult men is characterized by rapid onset of headache, vomiting, vertigo, ataxia and blurred vision. After this sudden onset the patients may present a stable course or a rapid or delayed onset of brain stem compression, revealed by impairment of consciousness. CT scan is the diagnostic method of choice. The correlation between angiographic and CT localization of the infarction is not good. For therapy the following policy is suggested: in alert and clinically stable patients: medical treatment (mannitol, glycerol, dexamethason), ICP and serial CT monitoring; in alert patients with hydrocephalus or mass effect: medical treatment and monitoring as mentioned before; ventricular drainage if ICP surpasses 350 mm H2O; in patients with impaired consciousness and hydrocephalus or mass effect: immediate ventricular drainage. If it is not followed by prompt improvement of the level of consciousness, an emergency suboccipital craniectomy with removal of the infarcted tissue should be done.
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PMID:Surgical management of acute cerebellar infarction. 398 89

Glycerol is a potent osmotic dehydrating agent with additional effects on brain metabolism. In doses of 0.25-2.0 g/kg glycerol decreases intracranial pressure in numerous disease states, including Reye's syndrome, stroke, encephalitis, meningitis, pseudotumor cerebri, central nervous system tumor, and space occupying lesions. It is also effective in lowering intraocular pressure in glaucoma and shrinking the brain during neurosurgical procedures. Hyperosmolality with rebound cerebral overhydration is of concern, especially in patients with altered blood brain barriers. They may be avoided if glycerol is administered on an intermittent rather than a continuous basis. Intravascular hemolysis does not occur with oral use. When administered intravenously, hemolysis can be minimized by using glycerol 10% in dextrose 5% with normal saline at rates of 6 mg/kg/min or less. However, intravenous doses of 1-2 g/kg every 2 hr can be administered safely in severe cases of elevated ICP. In such patients, glycerol serum concentration, serum osmolality and ICP monitoring are required to optimize glycerol therapy.
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PMID:Glycerol: a review of its pharmacology, pharmacokinetics, adverse reactions, and clinical use. 692 4

To clarify the pharmacokinetics and effect of ICP reduction of glycerol administered orally, the serum concentration of glycerol was measured by the enzymatic method and ICP was measured by the subdural balloon method in severe head injured patients with brain edema and increased ICP. Sequential change of serum glycerol concentration and its relationship to the reduction of ICP were analyzed. The results showed that the pharmacokinetics of glycerol through oral administration were similar to that of intravenous glycerol administration and the changes of ICP were also similar to that of intravenous glycerol administration. We determined that glycerol can be administered either per oral or per venous to obtain the same results for treatment of brain edema with raised ICP.
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PMID:Pharmacokinetics and pharmacodynamics of serum glycerol in patients with brain edema: comparison of oral and intravenous administration. 797 47

To investigate the more effective route of oral administration of glycerol to decrease the raised ICP, two different routes were employed in the clinical practice. The one was through a Naso-Gastric tube, and the other was through an Entero-Duodenal tube. Pharmacokinetics of glycerol in relation to the decrease of ICP, and the changes of other parameters which could influence the serum osmotic pressure were sequentially monitored for initial 30 minutes. In the group of Entero-Duodenal route, the time to reach to the maximum glycerol concentration (Tmax) was faster, the maximum concentration of glycerol (Cmas) was higher, and ICP reduction rate was greater than these in the group of Naso-Gastric route. Other parameters (Na, K, BUN and Glucose) showed no significant difference between the two routes. It can be concluded that the Entero-Duodenal administration of glycerol is the more effective route to decrease the raised ICP, when it is administered orally.
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PMID:Pharmacokinetics of serum glycerol and changes of ICP: comparison of gastric and duodenal administration. 977 36

The goal of intensive care management of patients with head injury is to provide them with a favourable physiological and metabolic environment for recovery of injury-compromised cells, and to prevent secondary brain insults. Clinical intracerebral microdialysis has enabled documentation of the metabolic derangement after head injury. Treatment targeted at this derangement has emphasized maintenance of optimal cerebral perfusion pressure (CPP). To determine the relationships between CPP and five clinically relevant intracerebral extracellular metabolites (glucose, lactate, glycerol, glutamate and pyruvate) in relation to different therapy intensities, 23 moderate to severe head-injury patients with hourly microdialysis samples were studied. These five metabolites were correlated with CPP and showed a biphasic relation at CPP of 65 to 67 mmHg, which was believed to be the critical CPP indicating irreversible brain damage. Relationship between intracerebral metabolites and CPP in relation to different therapy intensities was studied and suggests the critical CPP threshold in head-injured patients with high ICP and maximum therapy is elevated and should be maintained above 70 mmHg to prevent irreversible brain damage.
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PMID:Neurochemical changes in ventilated head-injured patients with cerebral perfusion pressure treatment failure. 1216 40

Matrix effects arising from ethanol, propanol, glycerol, acetic acid, ethylenediamine and triethanolamine in inductively coupled plasma mass spectrometry have been studied. Addition of ethanol, propanol, glycerol, acetic acid, ethylenediamine and triethanolamine into solution has an enhancement effect on the signal intensity of analyte with ionization potential between 9 and 11 eV. The ethylenediamine and triethanolamine have higher enhancement effect on the signal intensity of Hg than that of ethanol, propanol, glycerol and acetic acid. Addition of ethylenediamine and triethanolamine into solution has a suppression effect on the signal intensity of Pb and Sr. The mechanism of the enhancement or suppression was investigated. The signal enhancement of Hg in the presence of ethylenediamine and triethanolamine is not caused by improved degree of ionization of Hg and nebulization efficiency. The suppression effects of Pb and Sr in the presence of ethylenediamine and triethanolamine are due to decrease of atomization efficiency of these elements. A method for the determination of Hg in the biological standard samples by ICP-MS was developed.
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PMID:[Matrix effects in inductively coupled plasma mass spectrometry by use of organic solvents]. 1294 59


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