Oral glycerol for the treatment of traumatic intracranial hypertension

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  • 1 Division of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio
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✓ Hyperosmolar agents are a primary therapeutic modality employed in the treatment of traumatic intracranial hypertension. Profound hyperosmolarity accompanied by systemic dehydration is a potentially serious problem when these drugs are used repeatedly for control of intracranial pressure. Because glycerol, a water-soluble alcohol, is metabolized in the liver, its dehydrating capacity may be reduced in comparison to other agents. A series of 15 patients were treated with oral glycerol (0.5 to 1.0 gm/kg) with only minor changes in serum electrolytes, glucose, and urea nitrogen. Serum osmolarity rose from a baseline of 305 mOsm/liter to 355 mOsm/liter after 10 days of therapy. Glycerol was found to be effective and safe when employed in this protocol and proved to be a valuable adjunct to the standard methods available for control of intracranial hypertension.

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Address reprint requests to: Steven L. Wald, M.D., Surgical Associates Foundation, Inc., University Health Center, Inc., 1 South Prospect Street, Burlington, Vermont 05401.
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