naa a22 4500 510799779 CHVBK 20180411083349.0 cr unu---uuuuu 180411e20131001xx s 000 0 eng 10.1007/s12028-013-9824-3 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9824-3 Induced and Sustained Hypernatremia for the Prevention and Treatment of Cerebral Edema Following Brain Injury [Elektronische Daten] [Justine Ryu, Brian Walcott, Kristopher Kahle, Sameer Sheth, Randall Peterson, Brian Nahed, Jean-Valery Coumans, J. Simard] Cerebral edema develops in response to and as a result of a variety of neurologic insults such as ischemic stroke, traumatic brain injury, and tumor. It deforms brain tissue, resulting in localized mass effect and increase in intracranial pressure (ICP) that are associated with a high rate of morbidity and mortality. When administered in bolus form, hyperosmolar agents such as mannitol and hypertonic saline have been shown to reduce total brain water content and decrease ICP, and are currently the mainstays of pharmacological treatment. However, surprisingly, little is known about the increasingly common clinical practice of inducing a state of sustained hypernatremia. Herein, we review the available studies employing sustained hyperosmolar therapy to induce hypernatremia for the prevention and/or treatment of cerebral edema. Insufficient evidence exists to recommend pharmacologic induction of hypernatremia as a treatment for cerebral edema. The strategy of vigilant avoidance of hyponatremia is currently a safer, potentially more efficacious paradigm. Springer Science+Business Media New York, 2013 Hypernatremia nationallicence Brain injuries nationallicence Brain edema nationallicence Intracranial pressure nationallicence Stroke nationallicence Renal insufficiency nationallicence Ryu Justine Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut Walcott Brian Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut Kahle Kristopher Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut Sheth Sameer Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut Peterson Randall Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, Boston, MA, USA aut Nahed Brian Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut Coumans Jean-Valery Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut Simard J. Department of Neurosurgery, University of Maryland, Baltimore, MD, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/2(2013-10-01), 222-231 1541-6933 19:2<222 2013 19 12028 https://doi.org/10.1007/s12028-013-9824-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9824-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ryu Justine Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Walcott Brian Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Kahle Kristopher Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Sheth Sameer Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Peterson Randall Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Charlestown, Boston, MA, USA aut NATIONALLICENCE 700 1- Nahed Brian Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Coumans Jean-Valery Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, White Building Room 502, 02114, Boston, MA, USA aut NATIONALLICENCE 700 1- Simard J. Department of Neurosurgery, University of Maryland, Baltimore, MD, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/2(2013-10-01), 222-231 1541-6933 19:2<222 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer