Q: In the treatment of increased intracranial pressure (ICP), what is the equivalency of 23.4% of NaCl and Mannitol in terms of similar osmolar effect?
Answer: To be precise, 0.686 ml of 23.4% NaCl is equiosmolar to 1 gram/kg of 20% mannitol in effect.
The usual dose is 30-50 ml of 23.4% NaCl or 50-70 grams of mannitol q3-q6 hours as needed. Dose can be adjusted per clinical situation and lab osmolarity findings.
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References:
1. Ch. Lazaridis, R. Neyens, J. Bodle - High-osmolality saline in neurocritical care systematic review and meta-analysis - Crit Care Med, 41 (2013), pp. 1353-1360
2. Gisela Llorente, Maria Claudia Niño de Mejia, Mannitol versus hypertonic saline solution in neuroanaesthesia, Colombian Journal of Anesthesiology, Volume 43, Supplement 1, 2015, Pages 29-39,
ISSN 2256-2087, https://doi.org/10.1016/j.rcae.2014.07.010. (https://www.sciencedirect.com/science/article/pii/S2256208714000935)
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