Management of adverse effects in hyperosmolar therapy of brain edema

Background: Mannitol and hypertonic saline are the most frequently used hyperosmolar agents to treat cerebral edema resulting from acute brain injury. However, there several issues with using therapies. Here, we focus on potential adverse effects of therapies practical tips overcome these in neurointensive care unit.Current Concepts: Among used, mannitol may decrease intravascular volume pose a risk kidney injury for patients. Complications associated include central pontine myelinolysis, coagulopathy, electrolyte imbalances, metabolic acidosis, pulmonary edema. In addition, prolonged use increases hyperchloremic which be concomitant sodium acetate.Discussion Conclusion: Several laboratory variables were monitored unit limit possibly detect early complications related When agents, including saline, therapeutic purposes patients edema, determining whether peripheral or lines appropriate rate infusion dose can minimize their effects. Clinicians need aware events administering agents.