{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T20:58:08Z","timestamp":1770325088542,"version":"3.49.0"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1982,5]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 In 22 patients to be operated on for brain tumors or cerebral aneurysms, the effect of osmotic diuresis was compared with that of osmotic-loop diuresis on plasma and cerebrospinal fluid (CSF) electrolytes, and water and ion excretion. Mannitol or mannitol plus furosemide were used to reduce brain bulk. After treatment with thiopental and hyperventilation, patients received randomly a rapid infusion of mannitol (1.4 gm\/kg), or mannitol (1.4 gm\/kg) plus furosemide (0.3 mg\/kg). Brain shrinkage was considerably greater and more consistent with mannitol plus furosemide than with mannitol alone. However, hyponatremia, hypokalemia, hypochloremia, and hyperosmolality were also more marked (p &lt; 0.05) with mannitol plus furosemide than with mannitol. The rate of water and ion excretion was even more striking. At 30 minutes after absorption of mannitol alone, water excretion peaked at 17 ml\/min, and gradually decreased to 3.8 ml\/min 70 minutes later. With mannitol plus furosemide, during an identical time course, initial water excretion was 30 ml\/min, followed by a further rise to 42 ml\/min and then a decline to 17 ml\/min. At peak diuresis after mannitol, Na<jats:sup>+<\/jats:sup> and Cl<jats:sup>\u2212<\/jats:sup> excretion averaged 0.57 and 0.62 mEq\/min, respectively. This compares with mean values of 3.7 and 4.12 mEq\/min for Na<jats:sup>+<\/jats:sup> and Cl<jats:sup>\u2212<\/jats:sup>, respectively, after mannitol plus furosemide. Although optimum brain shrinkage is achieved with osmotic-loop diuresis, the rapid electrolyte depletion (Na<jats:sup>+<\/jats:sup> and Cl<jats:sup>\u2212<\/jats:sup>) must be corrected to avoid altered sensorium during the patients' postoperative course.<\/jats:p>","DOI":"10.3171\/jns.1982.56.5.0679","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:17:38Z","timestamp":1241799458000},"page":"679-684","source":"Crossref","is-referenced-by-count":44,"title":["Osmotic and osmotic-loop diuresis in brain surgery"],"prefix":"10.3171","volume":"56","author":[{"given":"Alfonso","family":"Schettini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Stahurski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harold F.","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Disturbances of Body Fluid Osmolality.","first-page":"227","article-title":"Pathophysiology of hyperosmolar states","author":"Arieff","year":"1977"},{"key":"b2","series-title":"Exp Brain Res","first-page":"503","article-title":"The effect of furosemide on sodium-22 uptake into cerebrospinal fluid and brain.","volume":"14","author":"Buhrley","year":"1972"},{"key":"b3","series-title":"Am J Physiol","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1152\/ajplegacy.1973.225.1.119","article-title":"Furosemide effect on isolated perfused tubules.","volume":"225","author":"Burg","year":"1973"},{"key":"b4","series-title":"Ann NY Acad Sci","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1111\/j.1749-6632.1966.tb41221.x","article-title":"Therapy with combinations of diuretic agents: comparative studies.","volume":"139","author":"Dettli","year":"1966"},{"key":"b5","series-title":"Exp Neurol","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/0014-4886(69)90005-3","article-title":"Effects of diuretics on cerebrospinal fluid formation and potassium movement.","volume":"24","author":"Domer","year":"1969"},{"key":"b6","series-title":"J Clin Pharmacol","first-page":"673","article-title":"Release of vasoactive materials from the kidney by diuretics.","volume":"17","author":"Hook","year":"1977"},{"key":"b7","series-title":"Brain Electrolytes and Fluid Metabolism.","first-page":"75","author":"Katzman","year":"1973"},{"key":"b8","series-title":"Ann NY Acad Sci","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1111\/j.1749-6632.1966.tb41219.x","article-title":"Physiologic and clinical observations on furosemide and ethacrynic acid.","volume":"139","author":"Laragh","year":"1966"},{"key":"b9","series-title":"J Pharmacol Exp Ther","first-page":"194","article-title":"The effect of acetazolamide and furosemide on cerebrospinal fluid production and choroid plexus carbonic anhydrase activity.","volume":"189","author":"McCarthy","year":"1974"},{"key":"b10","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1007\/BF01407228","article-title":"Intracranial hypertension and brain oedema in albino rabbits. Part 2: Effects of acute therapy with diuretics.","volume":"56","author":"Millson","year":"1981"},{"key":"b11","series-title":"Ann NY Acad Sci","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1111\/j.1749-6632.1966.tb41217.x","article-title":"Clinical use of furosemide.","volume":"139","author":"Reubi","year":"1966"},{"key":"b12","series-title":"Anesthesia and Neurosurgery.","first-page":"89","article-title":"Intracranial pressure control","author":"Rottenberg","year":"1979"},{"key":"b13","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1227\/00006123-197901000-00009","article-title":"Effect of furosemide on experimental traumatic cerebral edema.","volume":"4","author":"Tornheim","year":"1979"},{"key":"b14","series-title":"Steroids and Brain Edema.","first-page":"147","article-title":"Studies on the mechanisms of action of steroids in traumatized brain","author":"Tutt","year":"1972"},{"key":"b15","series-title":"Am J Physiol","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1152\/ajplegacy.1961.201.1.139","article-title":"Brain electrolytes and cortical impedance.","volume":"201","author":"Van","year":"1961"},{"key":"b16","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"203","DOI":"10.3171\/jns.1971.34.2part1.0203","article-title":"Diuretic synergy in the treatment of acute experimental cerebral edema.","volume":"34","author":"Wilkinson","year":"1971"},{"key":"b17","series-title":"J Clin Pharmacol","first-page":"663","article-title":"Furosemide and ethacrynic acid.","volume":"17","author":"Williamson","year":"1977"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/56\/5\/article-p679.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/56\/5\/article-p679.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/56\/5\/article-p679.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T12:52:55Z","timestamp":1658667175000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/56\/5\/article-p679.xml"}},"subtitle":["Effects on plasma and CSF electrolytes and ion excretion"],"short-title":[],"issued":{"date-parts":[[1982,5]]},"references-count":17,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/jns.1982.56.5.0679","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1982,5]]}}}