[Osmo-oncotherapy in brain edema]

Abstract

The treatment of cerebral edema must be directed towards improving the volume regulation of the brain cell which is disturbed due to reduced blood flow and hypoxia and towards restoring the disturbed function of the blood-brain barrier. Onco-osmotherapy increases the effective intracranial blood pressure difference and improves cerebral blood supply and oxygen absorption, thus exerting a positive effect on sodium concentration in the brain cell which is responsible for the intracellular corticocerebral edema. After renal excretion of the osmotherapeutic agent, however, water may again flow into the brain cell, depending on the osmotic gradient. When the function of the blood-brain barrier is disturbed, osmotherapy may lead to an undesired increase of the osmotic pressure in the tissue. In spite of this, onco-osmotherapy is one of the most effective measures in the treatment of cerebral edema. Choice of therapeutic agents, dosage, infusion rates, side effects and contraindications are dealt with in detail.