Cerebral dehydration action of glycerol; I. historical aspects with emphasis on the toxicity and intravenous administration

Introduction:
This text presents a comprehensive review of the use of glycerol as a cerebral dehydration agent, with a focus on its safety, efficacy, and potential advantages over other agents. The reader will learn about the historical context of glycerol use, its mechanism of action, toxicity concerns, and the results of various clinical and experimental studies.

Key Points:

* Glycerol has been used as a cerebral dehydration agent since the 1960s, with a proven track record of safety and efficacy.
* Glycerol's dehydration effect on the central nervous system is due to its osmotic properties and its exclusion from the brain, preventing the risk of rebound overhydration.
* The toxic effects of glycerol are a function of concentration and route of administration, and can be prevented by using isotonic saline as a diluent.
* Glycerol has been used intravenously in humans without significant adverse effects, and has been shown to reduce intraocular tension and cerebrospinal fluid pressure.
* Glycerol is not associated with the marked water and electrolyte washout seen with urea and mannitol, and can be used on a long-term basis.
* Glycerol's extrarenal mechanism of action suggests that it may be effective in nephrectomized animals, and it has been shown to reduce brain water without causing rebound overshoot of intracranial pressure.
* Glycerol's nutrient value (4.32 calories per gram) can supply a caloric yield greater than that supplied by an equal amount of glucose.

Main Message:
The text emphasizes the potential advantages of glycerol as a cerebral dehydration agent, particularly its long-term use and lack of significant water and electrolyte loss. The authors suggest that serious consideration should be given to the intravenous administration of glycerol as a means of controlling cerebral edema or CNS rehydration, especially in patients with encephalitis, meningitis, or postoperative swelling. Overall, the text provides a convincing argument for the use of glycerol as a safe and effective cerebral dehydration agent, with potential benefits over other agents in certain clinical scenarios.

Tourtellotte, Wallace W., James L. Reinglass, and Tracy a. Newkirk. “Cerebral Dehydration action of Glycerol; I. historical aspects with Emphasis on the Toxicity and Intravenous administration.” Clinical Pharmacology & Therapeutics 13, no. 2 (March 1972): 159–71. https://doi.org/10.1002/cpt1972132159.