Nincevic Zeljko, Mestrovic Julije, Nincevic Jasna, Sundov Zeljko, Kuscevic Dorjan
Department of Anaesthesiology and Intensive Care Medicine .
Brain Inj. 2015;29(6):766-71. doi: 10.3109/02699052.2015.1004743. Epub 2015 Mar 20.
The aim of the study was to investigate the effects of using low-dose mannitol (0.3 g kg(-1)) on the pulsatility index (PI) and minimum diastolic blood flow velocity (FV-min) of the middle cerebral artery in a traumatic brain injury (TBI).
Low-dose mannitol (0.3 g kg(-1)) was administered to a group of 20 patients with a TBI. Transcranial Doppler (TCD) ultrasonography was used to monitor the PI and FV-min. The study included patients with a diffuse traumatic brain injury and Glasgow coma score < 8. The initial TCD ultrasonography values were pathological (PI > 1.4 and FV-min < 20 cm s(-1)). TCD ultrasonography examinations were carried out before mannitol administration, immediately after administration and 1, 2 and 3 hours after the administration of mannitol.
A one-way analysis of variance revealed significant changes in the PI (F = 8.392; p < 0.001) and FV-min (F = 8.291; p = 0.001) after the use of mannitol.
Low-dose mannitol administration appears to be efficacious for improving the indicators of disturbed circulation in a TBI (FV-min increase, PI decrease). The maximum decrease in the PI was recorded 1 hour after the administration of mannitol and was 10.9% of the initial value. The maximum increase in the FV-min was recorded 1 hour after administration and was 29.7% of the initial value. These changes were significant ∼ 2 hours later.
本研究旨在探讨使用低剂量甘露醇（0.3 g·kg⁻¹）对创伤性脑损伤（TBI）患者大脑中动脉搏动指数（PI）和最小舒张期血流速度（FV-min）的影响。
对一组20例TBI患者给予低剂量甘露醇（0.3 g·kg⁻¹）。采用经颅多普勒（TCD）超声监测PI和FV-min。研究纳入弥漫性创伤性脑损伤且格拉斯哥昏迷评分<8分的患者。初始TCD超声值为病理性（PI>1.4且FV-min<20 cm·s⁻¹）。在甘露醇给药前、给药后即刻以及给药后1、2和3小时进行TCD超声检查。
单因素方差分析显示使用甘露醇后PI（F = 8.392；p < 0.001）和FV-min（F = 8.291；p = 0.001）有显著变化。
低剂量甘露醇给药似乎对改善TBI中循环紊乱指标有效（FV-min增加，PI降低）。PI的最大降幅在甘露醇给药后1小时记录，为初始值的10.9%。FV-min的最大增幅在给药后1小时记录，为初始值的29.7%。这些变化在约2小时后显著。
