Effects of Infusion of Hypertonic Mannitol on Electrolyte Balance and on Osmolarity of Serum and Cerebrospinal Fluid

Wise, Burton L.

doi:10.3171/jns.1963.20.11.0961

Cited by 32 publications

(25 citation statements)

References 11 publications

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“…Previous investigators have examined the influence of low-dose mannitol on serum electrolytes and osmolality, but the effects of high dose mannitol in man have not been fully investigated. 5,6 Therefore, the purpose of this study was to compare the intraoperative effects of 1 gm.kg -~ (referred to as "low"-dose in this study) and 2gm.kg -~ ("high'-dose) of mannitol on the serum and urine electrolyles and osmolality in neurosurgieal patients.…”

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confidence: 99%

The effect of high-dose mannitol on serum and urine electrolytes and osmolality in neurosurgical patients

et al. 1987

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The effect of mannitol on serum and urine electrolytes and osmolali~_ was investigated intraoperatively in neurosurgical patients. Patients in Group A (n = 7) received 1 gm,kg -t of 20 per cent mannitol ("low"-dose) Osmotic diuretics are used to reduce intracranial pressure and decrease brain bulk in neurosurgical patients, t'2 lntraoperatively, mannitol is most frequently administered in dose ranges of 0.25-1 gm.kg -I. More recently, high-dose mannitol (2 gm'kg -~) has been shown to have a protective effect in acute focal cerebral ischaemia. 3'4 Accordingly, high-dose maunitol may be given prior to temporary or permanent occlusion of a major cerebral

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mentioning

confidence: 99%

The effect of high-dose mannitol on serum and urine electrolytes and osmolality in neurosurgical patients

et al. 1987

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“…Intravenous infusion of hypertonic solution of mannitol has been shown to be effective in lowering intracranial pressure and decreasing the mass of brain, as well as lowering intraocular pressure5). Upon infusion of hypertonic mannitol (3 to 3.6 g/kg in 45 to 90 minutes), osmolarity of serum was increased from 28 to 42 mOsm/L), and the osmotic gradient between cerebrospinal fluid and serum was 16 to 35 mOsm/L5).…”

Section: Discussionmentioning

confidence: 99%

“…Upon infusion of hypertonic mannitol (3 to 3.6 g/kg in 45 to 90 minutes), osmolarity of serum was increased from 28 to 42 mOsm/L), and the osmotic gradient between cerebrospinal fluid and serum was 16 to 35 mOsm/L5). The decreased cerebrospinal fluid pressure is due to the movement of water from the brain into extracellular fluid.…”

Section: Discussionmentioning

confidence: 99%

Mannitol-induced Metabolic Alkalosis

Kang

Lee

et al. 2006

Electrolyte Blood Press

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Mannitol is an osmotic diuretic agent useful in a variety of clinical conditions. This study is based on acid-base and electrolyte changes seen after the intravenous infusion of hypertonic mannitol for the prevention of cerebral edema. The study subjects were divided into 3 groups: for group A, an amount of 300-900 mL 15% mannitol was intravenously infused over the period of 60 to 90 minutes; for group B, 1,200-2,600 mL over 12 to 24 hours; and for group C, 3,200-4,900 mL over more than 24 hours. In group A, blood pH is increased from 7.43±0.07 to 7.46±0.04, and plasma HCO3- from 25.3±2.1 to 28.9±2.9 mEq/L, but plasma K+ is decreased from 4.3±0.6 to 3.7±0.8 mEq/L. In group B, blood pH is increased from 7.42±0.02 to 7.47±0.06, and plasma HCO3- from 25.2±1.8 to 29.1±2.9 mEq/L, but plasma K+ is decreased from 4.2±0.3 to 3.8±0.5 mEq/L. In group C, blood pH is increased from 7.41±0.01 to 7.52±0.04, and plasma HCO3- from 24.9±1.2 to 27.7±2.5 mEq/L, but plasma K+ is decreased from 4.2±0.1 to 3.9±0.2 mEq/L. These results showed that intravenous infusion of mannitol could induce metabolic alkalosis and hypokalemia, regardless of its dose. The mannitol induced metabolic alkalosis may be due to increased renal HCO3- production.

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“…This water shift also dilutes serum sodium, transiently lowering serum sodium concentration. This is followed by clearance of mannitol from the circulation through the kidneys, producing an osmotic diuresis and elimination of a large volume of free water, further raising total body osmolality and serum sodium (17). Thus, the net effect of a single dose of mannitol is a no change or small net rise in total body osmolality.…”

Section: Time Course Of Osmotic Effects Of Mannitolmentioning

confidence: 99%

“…Hypertonic mannitol solutions rapidly draw water into the extracellular compartment increasing plasma volume (2), which transiently dilutes extracellular sodium (14)(15)(16). In the kidney, mannitol acts as an osmotic diuretic resulting in the excretion of large volumes of free water (2,17). The overall effect on osmolality depends on the type of intravenous fluids administered.…”

Section: Introductionmentioning

confidence: 99%