scholarly journals An Audit and Comparison of pH, Measured Concentration, and Particulate Matter in Mannitol and Hypertonic Saline Solutions

2021 ◽  
Vol 12 ◽  
Author(s):  
Christopher J. Carr ◽  
Jonathan Scoville ◽  
James Ruble ◽  
Chad Condie ◽  
Gary Davis ◽  
...  
Keyword(s):  
Particulate Matter ◽  
Light Microscopy ◽  
Physical Properties ◽  
Hypertonic Saline ◽  
Freezing Point ◽  
Vapor Pressure Osmometry ◽  
Hyperosmolar Therapy ◽  
All Solutions ◽  
Hyperosmolar Solutions ◽  
Concentration Measurements

Background: The preferred hyperosmolar therapy remains controversial. Differences in physical properties such as pH and osmolality may be important considerations in hyperosmolar agent selection. We aimed to characterize important physical properties of commercially available hyperosmolar solutions.Methods: We measured pH and concentration in 37 commonly-used hyperosmolar solutions, including 20 and 25% mannitol and 3, 5, 14.6, and 23.4% hypertonic saline. pH was determined digitally and with litmus paper. Concentration was determined by freezing point and vapor pressure osmometry. Salinity/specific gravity was measured with portable refractometry. Particulate matter was analyzed with filtration and light microscopy and with dynamic light scattering nephelometry.Results: pH of all solutions was below physiological range (measured range 4.13–6.80); there was no correlation between pH and solution concentration (R2 = 0.005, p = 0.60). Mannitol (mean 5.65, sd 0.94) was less acidic than hypertonic saline (5.16, 0.60). 14/59 (24%) pH measurements and 85/111 concentration measurements were outside manufacturer standards. All 36/36 mannitol concentration measurements were outside standards vs. 48/72 (67%) hypertonic saline (p < 0.0001). All solutions examined on light microscopy contained crystalline and/or non-crystalline particulate matter up to several hundred microns in diameter. From nephelometry, particulate matter was detected in 20/22 (91%) solutions.Conclusion: We present a novel characterization of mannitol and hypertonic saline. Further research should be undertaken, including research examining development of acidosis following hyperosmolar therapy, the relevance of our findings for dose-response, and the clinical relevance of particulate matter in solution.

\"Balanced hyperosmolar therapy\" using 3% hypertonic saline - 20% mannitol versus an equiosmolar volume of either 3% hypertonic saline or mannitol 20% in supratentorial tumor resection: A new approach to achieve hemodynamic stability

2021 ◽  
Vol 8 (2) ◽  
pp. 221-229
Author(s):  
Samir A Elkafrawy ◽  
Mahmoud K Khames ◽  
Islam M Kandeel
Keyword(s):  
Hypertonic Saline ◽  
Urine Output ◽  
Fluid Intake ◽  
Tumor Resection ◽  
Double Blind Study ◽  
Hemodynamic Stability ◽  
Hyperosmolar Therapy ◽  
Significant Difference ◽  
Brain Relaxation ◽  
The Brain

Both 3% hypertonic saline (3% HTS) and 20% mannitol were proven to be effective in relaxing the brain during supratentorial surgeries. This work aimed to study the effect of consecutive use of both drugs on the brain relaxation score and hemodynamic status during such surgeries.Ninety patients scheduled for supratentorial brain surgeries included in this prospective, randomized and double-blind study. Patients were allocated in three groups; HTS group (n=30) received 3 ml/kg 3% NaCl infusion over 30 minutes, HTS/M group (n=30) received mannitol 20% (1.4 ml/kg) as an infusion over 15 minute followed by 1.5 ml/kg 3% NaCl infused over 15 minutes and M group (n=30) received 3.2 ml/kg mannitol 20% infusion over 30 minutes. Brain relaxation was estimated. MAP and serum Na level were recorded at baseline and then at 30, 90 and 150 min. Total fluid intake, total urine output and operative time were recorded. Fluid intake and urine output were the highest with 20% mannitol (p ˂ 0.001). HTS/M and HTS groups showed no significance when satisfactory and fairly brain relaxation scores were added (p=0.862). MAP and CVP were near to baseline in HTS/M group at 30 and 90 min, while at 150 min no significant difference between groups. Serum hyperosmolarity was noticed in all groups at all check points but maximally with HTS group at 30 min (321.1 mOsm/L). Balanced hyperosmolar therapy using 3% HTS and 20% mannitol consecutively resulted in a satisfactory brain relaxation and allowed more hemodynamic stability.

scholarly journals Individualizing hyperosmolar therapy for management of intracranial hypertension

2018 ◽  
Vol 4 (2) ◽  
pp. 54-56
Author(s):  
Gentle Sunder Shrestha
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Hypertonic Saline ◽  
Significant Heterogeneity ◽  
Raised Intracranial Pressure ◽  
Threshold Method ◽  
Treatment Threshold ◽  
Hyperosmolar Therapy ◽  
Surgical Options ◽  
Selection Of

Intracranial hypertension is a major cause of morbidity and mortality in patients with brain injury. If not appropriately treated, it can precipitate brain ischemia, brain herniation and death. Hyperosmolar therapy remains the main armamentarium for management of raised intracranial pressure, especially in patients with diffuse lesions and where surgical options are not applicable. Substantial amount of studies have tried to explore the superiority of hypertonic saline or mannitol over the other. Due to significant heterogeneity in the pathophysiology of patients, variation in treatment threshold, method of drug administration and drug concentration, substantial evidence is lacking to support one agent over other. Hypertonic saline may be more effective than mannitol for lowering raised intracranial pressure. Well designed novel trials need to try to find the answer. Clinical, pathophysiological and biochemical data should be incorporated at bedside while individualizing selection of hyperosmolar therapy, with the aim to improve outcome and minimize harm.Journal of Society of Anesthesiologists of NepalVol. 4, No. 2, 2017, Page: 54-56 

System triethylamine–water: the equilibrium diagram and some physical properties

1967 ◽  
Vol 45 (10) ◽  
pp. 1089-1091 ◽  
Author(s):  
E. M. Kartzmark
Keyword(s):  
Thermal Analysis ◽  
Physical Properties ◽  
Freezing Point ◽  
Equilibrium Diagram ◽  
Solution Temperature ◽  
Critical Solution Temperature ◽  
Viscosity Measurements ◽  
Volume Of Mixing ◽  
Negative Volume

The freezing-point diagram, determined by the method of thermal analysis, corroborates the existence of a dihydrate, first discovered by Pickering (1). Density and viscosity measurements at 16.0 °C, slightly below the critical solution temperature of 18.3 °C, show marked non-ideality. The negative volume of mixing reaches a maximum at 50 mole % and the maximum in the viscosity (4.00 relative to water) occurs at 12 mole %.

Fast Membrane Osmometer as Alternative to Freezing Point and Vapor Pressure Osmometry

2008 ◽  
Vol 80 (7) ◽  
pp. 2617-2622 ◽  
Author(s):  
Alessandro Grattoni ◽  
Giancarlo Canavese ◽  
Franco Maria Montevecchi ◽  
Mauro Ferrari
Keyword(s):  
Vapor Pressure ◽  
Freezing Point ◽  
Vapor Pressure Osmometry

THE PREPARATION, PURIFICATION, PHYSICAL PROPERTIES AND HYDROLYSIS OF CYANOGEN CHLORIDE

1947 ◽  
Vol 25b (4) ◽  
pp. 381-386 ◽  
Author(s):  
D. E. Douglas ◽  
C. A. Winkler
Keyword(s):  
Activation Energy ◽  
Physical Properties ◽  
Vapour Pressure ◽  
Freezing Point ◽  
Cyanogen Chloride ◽  
Hydrolysis Of ◽  
Good Agreement

Cyanogen chloride, prepared by the method of Jennings and Scott, has been fractionally recrystallized to a constant freezing point of −6.90 °C. Vapour pressure values for material purified in this way are in good agreement with the data of Klemenc and Wagner. The activation energy for the hydrolysis of cyanogen chloride at pH 4 to 6 between 0° and 50 °C. is approximately 21 kcal. per mole.

Work of adhesion of respiratory tract mucus

1992 ◽  
Vol 72 (4) ◽  
pp. 1604-1610 ◽  
Author(s):  
R. S. Pillai ◽  
T. Chandra ◽  
I. F. Miller ◽  
J. Lloyd-Still ◽  
D. B. Yeates
Keyword(s):  
Cystic Fibrosis ◽  
Contact Angle ◽  
Vapor Pressure ◽  
Respiratory Tract ◽  
Physical Properties ◽  
Apparent Viscosity ◽  
Work Of Adhesion ◽  
Vapor Pressure Osmometry ◽  
Transport Defect ◽  
Measured Contact Angle

A method was devised to measure the work of adhesion (WA) to a substrate of mucus, a viscoelastic gel, from the measured contact angle of glycerol on a mucus substrate and the known physical properties of a Teflon surface. Fifteen sputum samples from cystic fibrosis (CF) patients were compared with 25 mucus samples from canine tracheal pouches (CP), studied in the hydrated and partially dehydrated states. Apparent viscosity (eta A) and recoverable shear strain (SR) were measured by fluxgate magnetometry, and water content was inferred from vapor pressure osmometry. Na+, K+, and Ca2+ concentrations were measured with specific ion electrodes and Cl- with a chloridimeter. The Cl- concentration of the CP mucus was inversely proportional to its osmolality, and the Cl- concentration of the CP mucus was 102.5 +/- 1.6 meq/l compared with 55.6 +/- 2.5 meq/l for CF sputum. When CP mucus osmolality was increased from 316.0 +/- 5.5 to 430.0 +/- 7.5 mosmol/kg, WA increased from 25.1 +/- 1.8 to 31.1 +/- 1.2 ergs/cm2 and eta A increased from 391 +/- 55 to 622 +/- 121 P, respectively. CF sputum WA was 30.2 +/- 0.6 ergs/cm2, eta A was 1,110 +/- 316 P, and osmolality was 466.0 +/- 14.0 mosmol/kg. The increased WA and eta A of mucus in CF patients may thus be dependent on the hydration of mucus, which is related to the documented Cl- transport defect.

612 Study on Physical Properties of Water around Freezing Point

2000 ◽  
Vol 005.1 (0) ◽  
pp. 199-200
Author(s):  
Atsumasa YOSHIDA ◽  
Katsuhiko HAYASHI ◽  
Kouji YOSHIZUMI ◽  
Seiichi WASHIO
Keyword(s):  
Physical Properties ◽  
Freezing Point
Sign in / Sign up

Export Citation Format

Share Document