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Osmotic Pump-based Drug-delivery for In Vivo Remyelination Research on the Central Nervous System
Published on: December 17, 2021
Osmotherapy: use among neurointensivists
Angela N Hays1, Christos Lazaridis, Ron Neyens
1Department of Neurosciences, Division of Adult Neurology, Medical University of South Carolina, Charleston, SC, USA. haysa@musc.edu
Neurocritical Care
|December 15, 2010
Summary
Practitioner preferences for osmotherapy agents like mannitol and hypertonic saline (HTS) for intracranial hypertension vary widely. Dosing and monitoring strategies also differ significantly among neurocritical care providers.
Area of Science:
- Neurocritical Care
- Neurosurgery
- Intensive Care Medicine
Background:
- Cerebral edema and intracranial hypertension are critical issues in neurological intensive care.
- Osmotherapy with mannitol or hypertonic saline (HTS) is a primary treatment.
- Existing literature lacks class I studies, leading to practice heterogeneity.
Purpose of the Study:
- To investigate the heterogeneity in clinical practice regarding osmotherapy for intracranial hypertension.
- To understand the choice of agent, dosing, and monitoring strategies used by clinicians.
Main Methods:
- An online survey was distributed to members of the Neurocritical Care Society.
- Multiple-choice questions focused on the use of mannitol and HTS.
Main Results:
- 295 responses were analyzed, predominantly from physicians (79.7%).
- Osmotherapy was used as needed (89.9%) rather than prophylactically.
- Practitioners were divided between HTS (54.9%) and mannitol (45.1%) preference, with HTS often reserved for refractory cases.
- Dosing regimens and monitoring parameters showed considerable variation.
Conclusions:
- Significant variability exists in the use of osmotherapy for cerebral edema treatment.
- This heterogeneity may impede the design and execution of multicenter clinical trials in neurocritical care.
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