failou

the manitol works in two phases. in the first one he is a volume expander and there is a dilutional hyponatremia .if the pt is already hyponatremic thus will lower the na+ further and as you know the most freqent cause of cerebral edema is na in the second phase he will dehydrate the brain and the vascular compartment.today the tendency to restrict fluids is replaced by euvolemia.no more dehydration. overdehydration will cause a lot of troubles(acidosis,atn,) thank you for the attention and i will be glad to participate in the forum. by-by

hello bellehil. i have no protocol for manitol but a few tips are available.i am sure you know all the benefits of manitol. better focus on what not doing. 1.dont give it to pt with hypotension 2.dont give it to pt with osmo>315-320 3.dont give to a pt dehydrated with high serum na+ 4.dont give ut to pt with hyponatremia. 5. dont give it to a pt with congestive heart failure(pulmonary edena) 6.dont give it slowly iv(20-30 min) 7.dont stop manitol at once(rebound). 8.be careful from a.t.n (nephrotoxicity) 9.to give manito to pt with contusions is controversial these are not the ten commandnents but i hope it helps let me know if you need more by-by