Castillo LB, Bugedo GA, Paranhos JL.; Crit Care Resusc. 2009 Jun;11(2):151-4.
Osmotically active solutions, particularly mannitol, have been used for more than 30 years in the treatment of intracranial hypertension. Recently hypertonic saline has emerged as an alternative to mannitol. Both solutions are used worldwide, and their indications and long-term side effects are well known.
More recently, knowledge about their effects has increased, both limiting and expanding their clinical use. Here, we compare the systemic and cerebral effects of mannitol and hypertonic saline, as well as their side effects and complications. Finally, we make recommendations about their clinical use.
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