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Abstract

Increased intracranial pressure is a further effect of brain injury due to structural damage and osmotic and water imbalances (Edema). Mannitol works in the proximal tubules and mannitol in the absorption of tubular cells by the mechanism of pinocytosis. The fluid transfer will draw fluid into the intracellular, so that the cell will be switched and broke. This phenomenon is referred to as the phenomenon of "Nephrosis Osmotic", in which mannitol administration may occur as a result of accumulation of drugs in the kidneys due to prolonged exposure to mannitol in the kidney and given dosage. The effects of osmotic diuresis occurring plus the dose and duration of mannitol administration are reported to cause renal function disorders (Scr and BUN). The aim of this study was to analyze changes in serum creatinine and BUN in patients with brain injury from before receiving mannitol therapy and during mannitol treatment. From the results of the study the number of patients who met the inclusion criteria, 32 patients. Serum creatinine, the initial average of 0.85 ± 0.17 mg / dl and the last day of the mean SCr 0.74 ± 0.30 mg / dl. While the mean BUN (Blood Urea Nitrogen) was 11.27 ± 2.75 mg / dl and the mean last day was 17.08 mg / dl ± 8.59 mg / dl. From Serum Creatinine and BUN data it can be concluded that there is no significant change.

Keywords

Mannitol Serum Creatinine BUN

Article Details

How to Cite
Sari, E. A., Suharjono, S., & Wahyuhadi, J. (2020). Monitoring Serum Creatinine, Blood Urea Nitrogen in Patients Brain Injury with Mannitol Therapy. Folia Medica Indonesiana, 56(4), 254–260. https://doi.org/10.20473/fmi.v56i4.24588

References

  1. Anonim. 2007 & 2016. The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care. Indications for intracranial pressure monitoring. J Neurotrauma. pp.49-56; 132-144.
  2. Bereckzi D., Liu M., Prado, D., & G.F Fekete, I., (2000). Cohcrane report: A systematic review of mannitol therapy for acute ischemic stroke and cerebral paranchemycal hemorrrhage.Stroke , pp.31,2719-2722.
  3. Bhat R., Hudson K., Sabzevasi T (2008). An Evidence Based Approach to Severe Traumatic Brain injury. EBMedicine. Vol.10. pp.12.
  4. Darmadipura PH., Kasan U., Bajamal HA., Turchan A., Parenrengi A & Wahyuhadi, J.,( 2010). Pedoman Diagnosis dan Terapi bag/SMF Ilmu Bedah Saraf. Surabaya: Rumah Sakit Umum Dokter Soetomo. pp.2-3.
  5. Dickenmann M, Oettl T, Mihatsch MJ (2008). Osmotic nephrosis: acute kidney injury with accumulation of proximaltubular lysosomes due to administration of exogenous solutes.American Journal Nephrology.pp51(3):491-503
  6. Dorman et al (1990). Mannitol induced acut renal failure.Journal Medicine vol.69 no.3.
  7. Dziedzic T, Szczudlik A, Klimkowicz A, Rog TM, Slowik A (2003). Is mannitol safe for patients with intracerebral hemorrhages? Renal considerations.ClinNeurolNeurosurg. 2003 Apr;105(2):87-9.
  8. Fang L., You, H., Chen, B., Xu, Z., Gao, L., Liu, J., et al., (2010). Mannitol is an independent risk factor of acute kidney injury after cerebral trauma: a case-control study.Journal Renal Failure.pp.673-679.
  9. Helmy, A., Vizcaychipi,M.,Gupta, A.K.(2009). Traumatic brain injury: intensive caremanagement. BrJAnaesth. ;99(1):32–42. 33
  10. Hinson H, Stein D, Sheth N.K, ( 2011). Hypertonic Saline and Mannitol therapy in critical care neurology.J Intensive Care Med. 2013 Jan-Feb;28(1):3-11.
  11. Li Mi, Chen T, Chen SD, Cai J, Hu YH (2015). Comparison of equimolar doses of mannitol and hypertonic saline for the treatment of elevated intracranial pressure after traumatic brain injury: a systematic review and meta-analysis.Medicine (Baltimore).May;94(17):e736
  12. Manninen P. H., Lam, A. M., Gelb, A. w., & Brown, S. C. ,(1987). The effect of high doses mannitol on serum and urine electrolytes and osmolarity in neurosurgical patients. Canadan Journal Anaestheology.pp. 442-6.
  13. Min Young Kim, M.D.,et al (2014). Increased risk of acute kidney injury associated with higher infusion rate of mannitol in patients with intracranial hemorrhage.Journal Neurosurgery. pp.1-9
  14. Moore M. E., Bellomo, R., Nichol, A., harley, N., MacIsaac, C., & Cooper, D. j.,(2010). The incidence of acute kidney injury in patient with traumatic brain injury.Journal Renal Failure. pp.1060-1065.
  15. Patro A & Mohanty S, 2009. Pathophysiology and treatment of traumatic brain edema.Indian Journal Neurotama Vol.6 No.1 pp 11-16.
  16. Pérez-Pérez AJ, Pazos B, Sobrado J, Gonzalez L, Gándara A (2002). Acute renal failure following massive mannitolinfusion.American Journal Nephrology. 2002 Sep-Dec;22(5-6):573-
  17. Rose BD , Post TW, (2007). Mechanism of actions diuretic.
  18. Shawkat H., Westwood MM., (2012). Manitol: a review of it's clinical uses. British Journal of Anesteshia.pp.1-4.
  19. Werner & Engelhard (2007). Pathophysiology of traumatic brain injury.British Journal of Anaesthesia99 (1): 4–9 (2007)

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