Intravenous Mannitol reduces intracompartmental pressure following tibia fractures: A randomized controlled trial  

作　　者：Jerry Nesaraj Viju Daniel Varghese P.R.Boopalan Manasseh Nithyananth Thambu David Sudarsanam Thilak Samuel Jepegnanam 

机构地区：[1]Christian Medical College,Vellore 632004,Tamil Nadu,India [2]Royal Darwin Hospital,Darwin 0810,Northern Territory,Australia

出　　处：《Chinese Journal of Traumatology》2021年第2期109-112,共4页中华创伤杂志（英文版）

基　　金：Internal Fluid Research Grant 7611.2011.

摘　　要：Purpose:Impending compartment syndrome is a common event following closed tibia fractures,which can progress to sinister compartment syndrome.Fasciotomy is the only definitive treatment available,though it has its own drawbacks and complications.Medical management at present consists of limb elevation and adequate hydration.This study aims at determining whether intravenous administration of Mannitol reduced the intracompartmental pressure in patients with closed tibial fractures.Methods:This is a double blinded,randomized control trial done in a single tertiary care center in India.Forty-five patients were recruited between February 2012 and October 2012.Forty patients who presented to the emergency department with isolated,closed,high velocity,and proximal 2/3 tibia fractures were included in this study.Patients with contraindication to Mannitol were excluded.They were allocated into 2 groups by the investigator using computer generated randomization.The pressure in the anterior compartment of the leg was measured with a handheld Stryker pressure monitor.Then either 20%Mannitol or 0.9%normal saline as given intravenously in a blinded manner,based on the randomization.The intracompartmental pressure was measured at 0,1 and 3 h after the infusion.The participant,investigator and statistician were masked to the group assessment.Results:There was no difference in intracompartmental pressures at 1 or 3 h,between the groups.However,in patients with the baseline of compartmental pressures30 mmHg,Mannitol showed a marked reduction in pressure of 8.5 mmHg at 1 h compared to almost no change in pressure in the saline group.There were no adverse events with the use of Mannitol.Conclusions:This preliminary study appears to show that Mannitol is useful in the management of the increased compartment pressure.The limitations of this study were that it only involved a small group of patients and the baseline pressures in both the groups were not comparable.More studies are required before the use of Mannitol as a standard of c

关 键 词：MANNITOL Compartment pressures Acute tibial fractures 

分 类 号：R68[医药卫生—骨科学]