The influence of mannitol on renal function during and after open-heart surgery.
Mannitol is often included in the priming solution of the heart-lung machine used during cardiopulmonary bypass (CPB). This study was set up to evaluate the effect of different doses of mannitol on human patients. Patients receiving 10 g of mannitol (n = 18) had an increased diuresis only during the bypass period (mean time = 87 min) when compared with a control group (n = 19) who did not receive mannitol. Patients receiving 20 g of mannitol (n = 19) had a significantly greater diuresis than both the control group and the 10 g group and the diuresis continued on throughout the immediate postbypass period (total mean time approximately 3 h). Patients receiving 30 g of mannitol (n = 20) also had a significantly greater diuresis that continued on during the first hour in the intensive care unit (ICU) (total mean time approximately 4 h). After 6 h in the ICU, all three groups of mannitol-treated patients equally demonstrated a trend towards an increased diuresis over the control group, which became a significant increase by 12 h in the ICU (p = 0.001) despite indications that the mannitol had been cleared from the body. These results suggest that there is an improvement of renal function post-CPB if mannitol is included in the CPB prime which may be due to an amelioration of the ischaemic effects of bypass on the kidneys.
Fisher
A R
AR
Heart Lung Department, Harefield Hospital, Middlesex, UK.
Jones
P
P
Barlow
P
P
Kennington
S
S
Saville
S
S
Farrimond
J
J
Yacoub
M
M
D001834:Body Water / Q000378:metabolism; D002314:Cardioplegic Solutions / Q000494:pharmacology; D002315:Cardiopulmonary Bypass; D000077324:Crystalloid Solutions; D004231:Diuresis / Q000187:drug effects*; D004234:Diuretics, Osmotic / Q000008:administration & dosage / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006355:Heart-Lung Machine; D006801:Humans; D007552:Isotonic Solutions; D007668:Kidney / Q000187:drug effects* / Q000502:physiology; D008297:Male; D008353:Mannitol / Q000008:administration & dosage / Q000494:pharmacology*; D008875:Middle Aged; D010952:Plasma Substitutes / Q000494:pharmacology; D011184:Postoperative Period
D002314:Cardioplegic Solutions; D000077324:Crystalloid Solutions; D004234:Diuretics, Osmotic; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D008353:Mannitol