Plangger C, Völkl H
Department of Neurosurgery, University of Innsbruck.
Zentralbl Neurochir. 1989;50(3-4):142-4.
Loop diuretics interfere with NaCl-KCl cotransport, which operates not only in the kidney but as well in a variety of nonepithelial cells including neuronal and glial cells. In these cells loop diuretics are able to reduce cellular volume. The present study has been performed to establish, whether furosemide or bumetanide directly modify intracranial pressure in cytotoxic brain edema. To this end, water intoxication was induced in animals acutely nephrectomized, to exclude any consequences of renal effects. Neither furosemide nor bumetanide proved effective in reducing intracranial pressure. In contrast, infusion of hypertonic mannitol solution leads to a marked, rapid reduction of intracranial pressure. The observations rule out a direct action of loop diuretics on intracranial cells to reduce intracranial pressure in water intoxicated animals.
袢利尿剂会干扰氯化钠-氯化钾协同转运，这种协同转运不仅在肾脏中起作用，在包括神经元和神经胶质细胞在内的多种非上皮细胞中也有作用。在这些细胞中，袢利尿剂能够减少细胞体积。本研究旨在确定呋塞米或布美他尼是否能直接改变细胞毒性脑水肿时的颅内压。为此，对急性肾切除的动物诱发水中毒，以排除肾脏效应的任何后果。结果表明，呋塞米和布美他尼在降低颅内压方面均无效。相比之下，输注高渗甘露醇溶液可导致颅内压显著快速降低。这些观察结果排除了袢利尿剂对水中毒动物颅内细胞直接作用以降低颅内压的可能性。
