BRAIN EDEMA

Aristya Nur F 030.12.033

Novita Valentina 030.12.192
Aristya Nur F 030.12.033
Novita Valentina 030.12.192
Aristya Nur F 030.12.033
Novita Valentina 030.12.192
 Maintain normovolemia or mild hypervolemia Monitor serum Na+
Maintain normotension Osmotic diuretics
Maintainance IV fluids : 0.9%, 2% or 3% saline Gradual taper of HS after 48-72 h with
Maintain normonatremia clinical and/or radiographic improvement

Head CT scan ( non-enhanced)

No mass effect
No compression of vital structures
GCS > 8

CEREBRAL EDEMA

GCS > 8 Head CT scan (non-enhanced) GCS ≤ 8

Mass effect
Compression of vital structures or shift

No ICP monitoring

Monitor GCS Serum Na+ goals 145-155 mEq/L ICP monitor

Maintain normovolemia or mild hypervolemia Monitor serum Na+
Maintain normotension Loop diuretics
Maintainance IV fluids : 2% or 3% saline

If ICP ≤ 20 mmHg If ICP ≤ 20 mmHg or

signs of
clinical herniation

Monitor GCS CSF drainage Serum Na+ goals 145-155 mEq/L

Maintain normovolemia or mild hypervolemia
Maintain normotension
Maintain CPP >80 mmHg
Maintainance IV fluids : 2% or 3% saline
Serum Na+ goals 145-155 mEq/L
Monitor serum Na+
Loop diuretics (Furosemide)
PCO2 25-30 mmHg
Loop diuretics
Maintain normovolemia
Maintain CPP > 60 mmHg
Mannitol 0.5-1.0 g/kg IV bolus
Serum osmolality goals 300-329 mOsm/L
23. 4% saline IV bolus for RIH
Maintenance IV fluids 2% or 3% saline
Monitor serum Na+
Pharmacologic coma (Phenobarbital)
Consider early decompressive surgery

BB 60 Kg
Mannitol : 20 gr / 100 ml
Initial dose : 0.5-1.0g /kg IV bolus Maintainance : 0.5 g / kg BB / 6 jam
1 g x 60 kg = 60 g 0.5 x 60 = 30 g
300 ml dalam 30-60 menit 150 ml / 6 jam

Aristya Nur F 030.12.033

Novita Valentina 030.12.192
Aristya Nur F 030.12.033
Novita Valentina 030.12.192