@article{Ahmad_Hanna_2014, title={Effect of equiosmolar solutions of hypertonic sodium lactate versus mannitol in craniectomy patients with moderate traumatic brain injury}, volume={23}, url={http://mji.ui.ac.id/journal/index.php/mji/article/view/686}, DOI={10.13181/mji.v23i1.686}, abstractNote={<p><strong>Background:</strong> Brain relaxation and prevention from cerebral edema are essential in craniectomy. Osmotherapy with 20% mannitol are generally used to withdraw fluid from the brain parenchyma, however may cause hemodynamic fluctuation, due to increase diuresis. On the other hand 0.5 M hypertonic sodium lactate (HSL) appeared as an alternative of osmotherapy. This study&nbsp; aimed to observe the effect of hypertonic sodium lactate (HSL) on brain relaxation, blood glucose level and hemodynamic variables in craniectomy due to moderate brain injury.</p> <p><strong>Methods:</strong> A randomized controlled study of 42 cases with moderate brain injury, aged 18 - 65 years, ASA 1 - 3, between September-November 2012, was carried out. The patients were divided into group M (n = 21) that received 2.5 mL/kg 20% mannitol and group HSL that received 2.5 mL/kg 0.5M HSL. Mean arterial pressures (MAP), central venous pressures (CVP) and urine output were measured after induction, and at 15, 30, 45, 60 min after infusion. Brain relaxation was assessed at a four-point scale after opening the duramater. Blood glucose levels were measured before induction and at 60 min after the infusion. Appropriate statistical tests were used for comparison. Unpaired t-test was used to compare hemodynamic and blood glucose level, and chi-square was used to compare brain relaxation.</p> <p><strong>Results:</strong> MAP at 60 minute was significantly higher in HSL group than M group (81.66 ± 7.85 vs 74.33 ± 6.18 mmHg; p = 0.002). There was no difference in brain relaxation (p = 0.988). A significant increase in blood glucose level was observed in group HSL (17.95 ± 11.46 mg/dL; p = 0.001).</p> <p><strong>Conclusion:</strong> Half-molar HSL was as effective as 20% mannitol in producing brain relaxation, with better hemodynamic stability and gave significant increase in blood glucose level.</p> <p><strong>Keywords:</strong> brain relaxation, hemodynamic, hypertonic sodium lactate, mannitol, traumatic brain injury</p&gt;}, number={1}, journal={Medical Journal of Indonesia}, author={Ahmad, Muhammad R. and Hanna, Hanna}, year={2014}, month={Mar.}, pages={30-5} }