| 만니톨 투여가 혈청삼투질 농도 및 수분과 전해질의 배설에 미치는 영항에 대한 연구 |
| 나덕렬, 윤병우,하충건,김병준,노재규,이상복,명호진,홍승봉,홍승철 |
| 서울대학교 신경과. 국군수도 통합병원. |
| Effect of Mannitol on Serum Osmolality and on Water and Electrolytes Excretion |
| Duk-Lyul Na,M.D., Byung-Woo Yoon,M.D., Choong-Kun Ha,M.D., Byoung-Joon Kim,M.D., Jae Kyu Roh,M.D., Sang-Bok Lee,M.D., Seung-Bong Hong,M.D., Seung-Cheol Hong,M.D. |
| Department of neurology , College of medicine, Seoul National University Capital Army General Hospital |
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| Abstract |
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The effect of mannitol on serum osmolality(Sosm) was studied in 13 patients with increased intracranial
pressure(Group I ) and 14 normal men(GroupII ).
All of the Patients in Gtoup I were given 0.5 g/kg dose of mannitol radipidly and blood samples for
Sosm were taken at 30 rninutes intetvals for the first one hour and at hourly intervals for the next 5
hours after mannitol infusion. Seven of Group II(Iia) received 0.5 g /kg dose of mannitol and the other 7
( II b) received 1.0 g / kg, Blood samples for Sosm and electrolytes were taken at the same intervals for
the same duration as in Group I expept for additionai blood samples every 5 rninutes during the first 30
minutes.
In Group I there was no significant rise in Sosm even 30 minutes after mannitol infusion. In Group Iia
and Iib, a maximum increase of 6 mOsm / kg, 14 mOsm / kg was observed at about 5 minutes, 25
minutes after mannitol infusion respectiveiy, which returned to baseline in about 1 hour and 4 hours
respectively.
The 1.0g /kg dose of mannitol produced a significant and relatively persistent increase in Sosm
probably enough to reduce the ICP, but at dose of 0.5 g / kg there was minimal increase in Sosm; which
seemed to be insufficient to reduce the ICP significantly as claimed in previous reports that there must be a Sosm rise of at least 10 mOsm / kg to have a significant reduction in ICP.
Also, to detemine the loss of water and electrolytes through urine after mannitol administration, the
urine volume and electrolytes were measeured at 30 minutes intervals for the first one hour and then
every hour thereafter for six hours in normal men(Group II). Water and electrolytes excretion rates and
urinary sodium concentrations were calculated in each interval. The author believes that these data
would be useful in estimating the amount of water and electrolytes that has to be replaced. |
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