A Pilot Study to Compare Effects of Mannitol with Hypertonic Saline in Combination with HES on Blood Coagulation and Platelet Function during Elective Craniotomy

Neurosurgery requires the use of osmotic agents to reduce intracranial pressure which can adversely affect coagulation. Thromboelastography provides early indicator of derangement of coagulation. A prospective, non randomized pilot study was conducted to compare the effect of administration of either mannitol or hypertonic saline and when combined with hydroxy ethyl starch on coagulation and platelet function, as measured by Thromboelastography. 22 neurosurgical patients, divided into 2 groups, received 20% mannitol (n=12) or 3% hypertonic saline (n = 10) followed by administration of hydroxy ethyl starch (HES). The Thromboelastography parameters were comparable in both the groups at baseline; after administration of the drug and also after HES administration. The results show that combining a single dose of either mannitol or hypertonic saline with hydroxyl ethyl starch does not appear to affect in-vivo coagulation.