Urazy głowy – najnowsze informacje

Tier 2 Therapy

A) Diuretics

Intracranial pressure can be aggressively addressed with the administration of osmotic diuretics. Osmotic diuretics such as mannitol should not be given to any patient without being certain that the patient has been volume resuscitated. If not, their use can precipitate acute renal failure. For this reason they are reserved as tier 2 therapies.

Mannitol improves cerebral blood flow and reduces intracranial pressure by decreasing oedema. After administration, mannitol expands the plasma volume and reduces blood viscosity, which improves cerebral blood flow and delivery of oxygen to the brain. Mannitol (0.5-2.0 g/kg) should be given as a bolus over 15 minutes to optimize the plasma expanding effect (Garosi and Adamantos, 2011). Mannitol reduces brain oedema over about 15-30 minutes after administration and has an effect for approximately two to five hours.

B) Seizure therapy

Post-traumatic seizures can cause further brain injury, contributing to morbidity and mortality associated with the head trauma. Recent large studies have reported the incidence of post-traumatic epilepsy (PTE) as 0.55-2% of all the dogs referred to veterinary hospitals (Friedenberg and others, 2012; Steinmetz and others, 2013). A study evaluating 50 dogs with TBI demonstrated that 10% of dogs went on to develop PTE and four out of the five of these dogs did not have any immediate [...]

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