Comparison between Hypertonic Saline 3% and Mannitol, the Most Commonly Used Osmotic Agents, Regarding Effect on Blood Pressure, Electrolytes Level and Acid Base Balance

Abstract
Background: Increased ICP following neurological injury can decrease CBF and may also lead to brain herniation and death so it should be lowered. Mannitol and HTS are the most commonly used osmotic agents for management of intracranial hypertension to improve the outcome.
Aim of Work: The aim of this study was to assess compli-cations of HTS and mannitol as they are commonly used for osmotherapy regarding effect on blood pressure, electrolytes level and acid base balance.
Material and Methods: 30 patients undergoing glaucoma surgery under general anesthesia were randomly allocated to 2 groups. One group recieved hypertonic saline 3% and the other group received mannitol. Mean arterial blood pressure was measured before infusion and then measured 5, 10, 20, 30, 60, 120min after end of infusion. Arterial blood gases (pH), and Na, k levels were measured at baseline (before infusion) and 60min after end of infusion.
Results: As regards MAP, both groups showed statistically significant increase in MAP initially followed by statistically significant decrease at 20min, 30min and 1h when collected data were compared to baseline.
Regarding Na level, there was statistically significant increase in Na level in HTS group in comparison to mannitol group despite being within normal range of Na level.
As to K level, both groups showed statistically significant decrease in K level. As regards PH, there was no statistically significant difference between both groups at baseline and after infusion.
Conclusion: Both HTS and mannitol had the same effect on MAP, K level and PH. Regarding Na level, it was increased slightly in HTS group while decreased in mannitol group.