Furosemide and Mannitol in the Treatment of Acute Experimental Intracranial Hypertension

Intracranial hypertension was induced in dogs and a small number of baboons by the inflation of epidural balloons. The resulting increased intracranial pressure (ICP) was treated with standard clinical doses of furosemide (0.7 mg/kg), "mini" doses of mannitol (0.75 g/kg), or both agents in combination. Mannitol consistently and rapidly reduced ICP in all animals. When results were averaged, furosemide used alone caused a slow reduction in ICP, but the results were variable in individual animals--with ICP actually increased in some. When furosemide and mannitol were given together, the ICP fell rapidly and remained low for considerably longer than after either agent alone.