Metabolic consequences of a sorbitol overdose during neurosurgery.
The authors present a case of severe electrolyte and acid-base disturbances after administration of sorbitol. The rate of sorbitol infusion was in excess of the stated maximum safe infusion rate in parenteral nutrition. Sorbitol was used for treating raised intracranial pressure. The mechanisms of sorbitol metabolism leading to hyperlactacemia, lactic acidosis, hyperuricemia, depletion of intracellular ATP and ADP and depletion of inorganic phosphates are described.
Buijs
E J
EJ
Institute of Anesthesiology, University of Utrecht, The Netherlands.
van Zuylen
H J
HJ
D000140:Acidosis, Lactic / Q000139:chemically induced*; D000244:Adenosine Diphosphate / Q000097:blood; D000255:Adenosine Triphosphate / Q000097:blood; D000768:Anesthesia, General; D018681:Anesthetics, General; D001786:Blood Glucose / Q000378:metabolism; D003907:Dexamethasone / Q000627:therapeutic use; D004234:Diuretics, Osmotic / Q000008:administration & dosage / Q000009:adverse effects*; D062787:Drug Overdose; D004573:Electrolytes / Q000097:blood*; D005045:Etomidate; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D061389:Insulin, Regular, Pork; D002532:Intracranial Aneurysm / Q000601:surgery*; D007773:Lactates / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery; D010710:Phosphates / Q000097:blood; D015742:Propofol; D011559:Pseudotumor Cerebri / Q000517:prevention & control; D013012:Sorbitol / Q000008:administration & dosage / Q000009:adverse effects*; D017409:Sufentanil; D014527:Uric Acid / Q000097:blood*
D018681:Anesthetics, General; D001786:Blood Glucose; D004234:Diuretics, Osmotic; D004573:Electrolytes; D007328:Insulin; D061389:Insulin, Regular, Pork; D007773:Lactates; D010710:Phosphates; D014527:Uric Acid; D013012:Sorbitol; D000244:Adenosine Diphosphate; D003907:Dexamethasone; D000255:Adenosine Triphosphate; D017409:Sufentanil; C000006:insulin, neutral; D015742:Propofol; D005045:Etomidate