JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

Anesth Analg 1979; 58:42-48
© 1979 International Anesthesia Research Society
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Stiff, J. L.
Right arrow Articles by Bromberger-Barnea, B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Stiff, J. L.
Right arrow Articles by Bromberger-Barnea, B.

Hypotension and Respiratory Distress Caused by Rapid Infusion of Mannitol or Hypertonic Saline

Judith L. Stiff, MD*, Douglas F. Munch, BChE{dagger}, and B. Bromberger-Barnea, PhD{ddagger}

*Assistant Professor Department of Anesthesiology. {dagger}Department of Biomedical Engineering and Environmental Physiology, The Johns Hopkins University School of Medicine. {ddagger}Professor of Environmental Health Sciences, The Johns Hopkins School of Hygiene and Public Health. Department of Anesthesiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.

Abstract

Following a case of mannitol-induced respiratory and circulatory collapse, the effects of hyperosmolar injections on pulmonary arterial pressure, systemic blood pressure, and cardiac output were studied in dogs. The injection of 20 ml of 10% NaCI into the pulmonary artery increased pulmonary arterial pressure and decreased systemic blood pressure by approximately 50% of control values. Injections of solutions of equal hyperosmolar strength, 50 ml of 25% mannitol or 50 ml of 4% NaCI into the pulmonary artery produced no significant elevation of pulmonary arterial pressure, but were associated with comparable decreases in systemic blood pressure. When allowed to vary, cardiac output increased with injections of all three hyperosmolar solutions, yet was still accompanied by falls in systemic blood pressure as large as when cardiac output was held constant. Vagotomy did not prevent these changes in systemic and pulmonary arterial pressure nor the increase in cardiac output. After five to 10 injections, the decreases in systemic blood pressure with any of the solutions and the increases in pulmonary arterial pressure with 10% NaCI disappeared and further injections were without effect. It is concluded that administration of mannitol probably does not cause pulmonary edema due to fluid overload, nor does it cause heart failure as evidenced by increases in pulmonary arterial pressure. However, rapid injection may cause a fall in blood pressure and may on occasion be accompanied by bronchospasm especially in sensitive subjects.

Key Words: FLUID BALANCE: hypertonic solutions • BLOOD PRESSURE: hypertonic solutions and






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1979 by the International Anesthesia Research Society.