Acute mannitol intoxication in a patient with normal renal function.
A young, previously healthy patient with multiple trauma mistakenly received 400 grams of mannitol over a 3-hour period. The laboratory report of hyponatremia prompted treatment with hypertonic saline before the hyperosmolar state was recognized. The osmolal gap was 118. Mannitol intoxication in a patient without preexisting renal failure is unusual. Identification of an abnormal osmolal gap and recognition of the hyperosmolar state is discussed.
Huff
J S
JS
Division of Emergency Medicine, Eastern Virginia Graduate School of Medicine, Norfolk.
D000063:Accidents, Traffic; D000328:Adult; D004630:Emergencies; D006801:Humans; D007668:Kidney / Q000378:metabolism; D008297:Male; D008353:Mannitol / Q000008:administration & dosage / Q000009:adverse effects*; D008508:Medication Errors; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D009994:Osmolar Concentration; D011859:Radiography; D012462:Saline Solution, Hypertonic / Q000009:adverse effects*
D012462:Saline Solution, Hypertonic; D008353:Mannitol