title: Use of mannitol during neurosurgery: interpatient variability in the plasma and CSF levels.
abstract: An i.v. infusion of mannitol was given over 15 min to 12 patients before they underwent intracranial surgery under general anesthesia. Samples of blood, CSF and urine were taken over 4 h. Mannitol disappeared from plasma in a bi-exponential manner. The mean maximal plasma concentration was 4.08 mg/ml at 15 min, and at 4 h it had declined to 0.53 mg/ml. The mean distribution rate constant was 11.2 h-1, corresponding to a plasma distribution half-life of 0.11 h. The mean elimination rate constant was 0.41 h-1, the plasma half-life was 2.2 h, the central distribution volume was 16.3 l, and total plasma clearance was 100.4 ml/min. The mean concentration of mannitol in CSF during the 4 h period increased up to 0.10 mg/ml. There were marked interindividual differences in the concentration ratio blood/CSF, and the CSF concentration varied 7.5 fold between patients. Optimal use of mannitol during neurosurgery requires further prolonged study of its pharmacokinetics.
authors.affiliation: Department of Clinical Pharmacology, Karolinska Hospital, Stockholm, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Anderson
authors.forename: L
authors.initials: L
authors.lastname: Boréus
authors.forename: E
authors.initials: E
authors.lastname: Gordon
authors.forename: M
authors.initials: M
authors.lastname: Lagerkranser
authors.forename: A
authors.initials: A
authors.lastname: Rudehill
authors.forename: C
authors.initials: C
authors.lastname: Lindquist
authors.forename: G
authors.initials: G
authors.lastname: Ohman
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000601:surgery*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008353:Mannitol / Q000097:blood / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics*; D008875:Middle Aged
chemical_list: D008353:Mannitol