[Rebound phenomenon of mannitol and glycerol: clinical studies]

A rebound phenomenon after infusion of hypertonic solution of mannitol and glycerol on raised intracranial pressure was studied by epidural pressure recordings for 65 patients. The mean age of the patients was 50 years with a range of 29 to 73 years. The diagnoses of above patients were as follows; 29 were cerebral aneurysms, 19 were brain tumors, 10 were hypertensive intracerebral hemorrhages, 4 were cerebral contusions, 2 were arteriovenous malformations, and one was cerebral abscess. Four methods of infusion were performed. In group A, 0.5 g/kg of mannitol was infused within 15, 30 or 60 minutes. In group B, 1.0 g/kg of mannitol was infused within 30, 60 or 90 minutes. In group C, 0.5 g/kg of glycerol in 5% fructose was infused within 30, 60 or 90 minutes. In group D, 1.0 g/kg of glycerol in 5% fructose was infused within 60, 120 or 180 minutes. The following observations were examined in all patients. (1) The occurrence of the rebound phenomenon. (2) The rate of the raised intracranial pressure (ICP) compared to the ICP before infusion of these hypertonic solutions. (3) The duration of the rebound phenomenon.

A rebound phenomenon was found 23% in all patients, and 12% in the mannitol groups and 34% in the glycerol groups. The dose and the rate of mannitol infusion did not influence the occurrence of the rebound phenomenon. In contrast, in the glycerol groups, the infusion method did influence the occurrence of the rebound phenomenon.(ABSTRACT TRUNCATED AT 250 WORDS)