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March 6, 1937

CLINICAL EXPERIENCE IN THE USE OF SUCROSE INSTEAD OF DEXTROSE

JAMA. 1937;108(10):773-776. doi:10.1001/jama.1937.02780100003002
Abstract

Since 1922, concentrated dextrose solution injected intravenously has been widely recommended and used in the management of cases of acute brain injury for the purpose of reducing excessive intracranial pressure.1 Almost from the inauguration of this osmotic therapy, various critics advanced suspicions and ostensible proofs that it does not regularly reduce intracranial pressure and that, when it does, the reduction is followed by a reactive elevation.2

Notwithstanding these criticisms of intravenous, concentrated dextrose therapy, the method has continued in use. Sachs,3 one of the earliest sponsors of osmotic treatment of increased intracranial pressure, pointed out in 19334 that the occurrence of a secondary rise of pressure is beside the point clinically, as no one relies on a single dose of dextrose in a serious case. Later doses, at intervals of from four to six hours, can be relied on to overcome the secondary elevation along with

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