Mannitol-induced Metabolic Alkalosis.
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.
Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Chonbuk, Korea.
Kyung Pyo
KP
Kang
Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Chonbuk, Korea.
Sik
S
Lee
Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Chonbuk, Korea.
Kyung Hoon
KH
Lee
Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Chonbuk, Korea.
Sung Kyew
SK
Kang
Mannitol; Metabolic alkalosis