[Optimization of osmotherapy using an intracranial pressure-dependent automatic control system in the postoperative...

A new system of a cerebral-pressure dependent infusion therapy with sorbitol enabling an optimization of the osmotherapy is described. This system was applied to a total of 104 patients. The developed system controls a isorbitol infusion pump in dependence upon the VFP (ventricular fluid pressure). In this system preset normal values of the pressure, maximum amount of flow, and the inertia of the control process can be varied. The employment of this therapy form leads to characteristic courses of the cerebral pressure, which we call control cycles. A total of 626 control cycles with various time constants and preset normal values were evaluated. After calculation of the regression equations generalizing conclusions with respect to the brain pressure behaviour in dependence upon the sorbitol consumption were possible. The results permit to draw conclusions with respect to the optimum application of sorbitol in the treatment of cerebral oedemas even without using the described system.