How to use dehydrating agents to reduce intracranial pressure in patients with brain tumors

Increased intracranial pressure is one of the main manifestations of brain tumors. In severe cases, brain herniation may even occur, which is life-threatening. Dehydrating drugs can increase the osmotic pressure, causing an osmotic pressure gradient between plasma and brain tissue. Water moves from brain tissue into plasma, dehydrating the brain tissue and reducing intracranial pressure.

When using dehydrating agents, the following points should be noted:

1. Use 20% mannitol intravenously at the beginning of radiotherapy, and use it as appropriate during radiotherapy according to the condition.

2. When using dehydrating agents, keep the airway open and inhale oxygen when necessary. Raise the head of the bed 15 to 30 degrees and avoid twisting the neck or compressing the chest to facilitate jugular vein return and reduce intracranial pressure.

3. Closely observe changes in the patient's condition, regularly measure body temperature, pulse, respiration, and blood pressure, and pay attention to changes in intracranial pressure. If systolic blood pressure increases and the pulse is slow and strong, you should be alert to acute increase in intracranial pressure.

4. Dehydrating agents can be used in combination with hormones, such as adding dexamethasone to 20% mannitol for intravenous drip. However, after taking the medicine, pay attention to whether there is any disorder in water and electrolytes, limit fluid intake, and record the fluid intake and output for 24 hours.

5. Keep bowel movements open to avoid straining during bowel movements, which may cause a sudden increase in intracranial pressure and lead to brain herniation.

6. For comatose patients, ice bags or ice caps can be used to cool the head to reduce oxygen consumption of brain tissue cells and help reduce cerebral edema, but pay attention to changes in body temperature to prevent frostbite.

Tips: The metabolites of mannitol in the body can be converted into glucose, so it should be used with caution in brain tumor patients with diabetes.