Perbandingan Efektivitas Natrium Laktat dengan Manitol untuk Menurunkan Tekanan Intrakranial Penderita Cedera Kepala Berat

Abstract

Increasing of intracranial pressure still a main cause of death in head injury patient. A new osmotic therapy probably an alternative to decrease intracranial pressure. A prospective randomized double blind study was done in 20 severe head injury in Dr. Hasan Sadikin Hospital Bandung emergency unit during February–July 2009. Subjects were divided in 2 groups, the first group was treated by natrium lactate and the second group was mannitol. We measured intracranial pressure, lactate concentration, potassium and natrium concentration before and after treatment. The statistical analysis were performed by using Shapiro-Wilk test for distribution analysis and paired t-test or Wilcoxon test for mean comparison using statistical products and solution services (SPSS) program. Intracranial pressure decreased in natrium lactate group (p<0.001) with increased of lactate concentration (p=0.035). In mannitol group we get a decreased in intracranial pressure (p=0.005), and in lactate concentration (p=0.135). No significant changed of potassium and natrium concentration in each group. No significant intracranial decrease for natrium lactate versus mannitol was apreciated (p=0.417), but a significant different in lactate concentration (p=0.016). We noticed lactate concentration in natrium lactate had a higher increase. In conclusions, we noticed a significant intracranial pressure decreased by manitol as same as natrium lactate treatment. Natrium lactate administration was increasing lactate concentration significantly than mannitol done. No significant difference in natrium and potassium was noticed in both groups.

Keywords

• Intracranial pressure
• mannitol
• natrium lactate
• severe head injury