What is the purpose of hyperosmolar therapy in acute TBI management?

• A. Draws fluid from brain tissue into vascular space to reduce ICP.
• B. Increases CSF production.
• C. Directly reduces brain oxygen consumption.
• D. Causes sedation.

Answer: (A)

Hyperosmolar therapy lowers intracranial pressure by pulling water out of swollen brain tissue into the blood vessels, creating an osmotic gradient that reduces brain volume. In acute TBI, high ICP can impair cerebral perfusion; by drawing water from the brain into the vascular space, this therapy lowers ICP and helps restore cerebral perfusion pressure and oxygen delivery to brain tissue. The effect comes from increasing serum osmolality with agents like hypertonic saline or mannitol, which drives water out of the brain. It does not directly increase CSF production, does not directly reduce brain oxygen consumption, and is not a sedative.