Effect of Mannitol on Cerebrospinal Fluid Pressure

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Abstract
In the search for a safe and effective hypertonic solution to lower cerebrospinal fluid (CSF) pressure and decrease brain bulk, many agents have been tested.1-4Recently, 30% urea solution has been utilized for this purpose.5 Hypertonic solutions of mannitol have been used extensively in animals and humans6-8without evidence of toxicity. Mannitol is confined mainly to the extracellular space, is metabolized little if at all, and is excreted fairly rapidly.9-10Thus, on theoretical grounds, it appeared that hypertonic mannitol solution, administered intravenously, might be an excellent agent for lowering CSF pressure and reducing brain bulk. Methods Dogs were anesthetized by the intravenous administration of sodium pentobarbital (25 mg/kg), and supplemental anesthetic as needed. An endotracheal tube was inserted and attached to a respirator. Respiration was controlled throughout all experiments. A needle in the cisterna magna was connected to a Statham strain gauge manometer, and cerebrospinal fluid