Introduction: Mannitol was used in traumatic brain injury but controversy about the onset and duration.
Setting: Clinical observational study.
Methods: Fourteen traumatic brain injured patients with a Glasgow Coma Scale (GCS) score < or = 8 were enrolled. Group I patients (n = 8) with intracranial pressure (ICP) < 20 mmHg, and group II patients (n = 6) with ICP > or = 20 mmHg underwent transcranial Doppler (TCD) monitoring and blood samples were drawn every 5 minutes during the post-operation period. Several parameters were compared with statistical analysis between both groups.
Results: The ICP declined during a 30-minute recording in both groups and the decline of ICP was significant (p < 0.05) at the 10-minute interval in group II. The decline of hemoglobin (Hb) and oxygen content (CaO2), increase of venous pressure (CVP) and 02-transport ability (CeDO2) at 10-minute were also statistically significant (p < 0.05) in group II as compared to the group I. Using a regression model between both comparisons, several parameters were statistically different at the 10-minute interval after mannitol infusion.
Conclusions: The dynamic responses can happen as early as 5-10 minutes after mannitol infusion, and had a greater effect on traumatic brain injury patients with ICP > or = 20 mmHg. It demonstrated a significant dynamic difference between both groups. All these changes can be monitored by TCD and peripheral blood tests.