Effects of Single, Repeated and Massive Mannitol Infusion in the Dog

Stuart, Frank P.; Torres, Esther; Fletcher, Roger; Crocker, Diane W.; Moore, Francis D.

doi:10.1097/00000658-197008000-00004

Cited by 44 publications

(22 citation statements)

References 10 publications

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“…Despite the wide use of mannitol in the clinical setting, the effect of therapeutic dosages on electrolyte concentrations, urine production, and renal function variables (eg, GFR, fractional excretion [FE] of solutes) have rarely been reported in the veterinary literature. Previous studies investigating the effects of mannitol on the structure and function of the kidney did not mimic the clinical settings and therapeutic dosages in which this osmotic diuretic is used . These studies did determine, however, that mannitol might be associated with adverse effects in both human patients and dogs .…”

Section: Introductionmentioning

confidence: 51%

Sequential changes in urine production, glomerular filtration rate, and electrolyte excretion after mannitol administration

Segev

Stafford

Kirby

et al. 2019

Veterinary Internal Medicne

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Introduction Acute kidney injury (AKI) leading to severe uremia is associated with high morbidity and mortality. Mannitol is an osmotic diuretic, widely used in the management of AKI, both as a bolus injection and as a constant rate infusion (CRI). Objectives To determine the plasma concentration of mannitol after a bolus injection and CRI at the recommended dosages, and to assess the effect of mannitol on renal function variables including urine production, glomerular filtration rate (GFR), and solute excretion. Methods Prospective cross‐over design study, using 6 healthy dogs. Each dog underwent 3 protocols with at least a 7‐day washout period between protocols. The first protocol included bolus injection of mannitol, the second protocol included bolus injection followed by CRI of mannitol and the third protocol (control) included injection of 5% dextrose in water (D5W). Urine production, GFR, and fractional excretion (FE) of solutes were measured for 10 hours. Results For all protocols, urine production significantly ( P < .001) increased after bolus injection, but no significant difference in urine production or GFR was observed among the treatment groups. Mannitol injection increased the FE of sodium and urea nitrogen, but these effects were short ‐ lived. Conclusions Mannitol has minimal effect on urine production and GFR but does increase FE of urea nitrogen and sodium, immediately after bolus injection. Constant rate infusion at a conventional dosage of 1 mg/kg/min cannot maintain these effects in dogs with normal renal function, because mannitol concentration decreases rapidly.

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Section: Introductionmentioning

confidence: 51%

Sequential changes in urine production, glomerular filtration rate, and electrolyte excretion after mannitol administration

Segev

Stafford

Kirby

et al. 2019

Veterinary Internal Medicne

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“…It should be kept in mind that a comparison of GPS and GPM did not produce any real difference in energy-limited growth of rats, which proves equal utilisation of bound sorbitol and mannitol respectively. This finding is at variance with the reported, almost complete non-utilisation of free mannitol [15,17,20,27,29,41,44,49,54]; it remains to be seen whether the established slow release of mannitol from GPM (Table 1), leading to a constant, though small availability of this hexitol during intestinal passage (Table 2), could suffice to explain the different behaviour of free and glycoside-bound mannitol. Some differences between sorbitol and GPS seem to fall into the same category since free sorbitol, in contrast to GPS, does not exhibit reduced caloric utilisation in maintenance experiments 3.…”

Section: Discussionmentioning

confidence: 70%

Metabolism of hydrogenated palatinose, an equimolar mixture ofα-D-glucopyranosido-1,6-sorbitol andα-D-glucopyranosido-1,6-mannitol

Grupp

Siebert

1978

Res. Exp. Med.

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Hydrogenated palatinose, an equimolar mixture of alpha-D-glucopyranosido-1,6-sorbitol and alpha-D-glucopyranosido-1,6-mannitol, was investigated as a potential oral sugar substitute in the following experiments in man and rat. 1. Enzymatic cleavage occurred at slow rates by maltase (alpha-glucosidase) of jejunal mucosa, liver lysosomes and yeast. 2. Part of ingested hydrogenated palatinose arrived unsplit at the caecum of the rat and underwent fermentation there; excretion in feces and urine are neglegible in man and rat. 3. Growth and maintenance of rats demonstrated 20--40 percent diminished caloric utilisation of diets containing 34.5 percent hydrogenated palatinose whereas indirect calorimetry in man showed about 50 percent caloric deficit. 4. Blood sugar did not increase in man after oral doses up to 100 g. 5. The capacity of the rat kidneys for excretion of hydrogenated palatinose and its constituents was high, symptoms of incompatibility were not observed.

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“…Hypotension with rapid administration (< 5min), 47,48 rebound increase in ICP, 47,49 volume overload and electrolyte imbalances which include hyponatremia 50 or hypernatremia 51 and early but transient decrease of serum bicarbonate and increases in serum potassium. 19 So,in search for an alternate therapy, in 1988 Worthley et al first found that HTS reduced ICP in patients that were refractory to mannitol.…”

Section: Hyperosmolar Therapymentioning

confidence: 99%

Management of intracranial hypertension: Recent advances and future directions

Shrestha

Pradhan

2017

Bangladesh Crit Care J

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Intracranial hypertension is a major cause of morbidity and mortality in critically ill patients. Great deal of research has been done with the goal to improve patient outcome, but the challenges are enormous. From basic managementlike sedation and analgesia, to higher tier therapies, there are mixed evidences, some indicating these interventions to be beneficial and some to be equivocal, but the paucity of high-quality trials limits strong recommendations. This review will try to analyze the extensive literature regarding management of raised intracranial pressure, with particular focus on recent advances and will also try to shed some light on future directions.Bangladesh Crit Care J March 2017; 5(1): 53-62

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Effects of Single, Repeated and Massive Mannitol Infusion in the Dog

Cited by 44 publications

References 10 publications

Sequential changes in urine production, glomerular filtration rate, and electrolyte excretion after mannitol administration

Sequential changes in urine production, glomerular filtration rate, and electrolyte excretion after mannitol administration

Metabolism of hydrogenated palatinose, an equimolar mixture ofα-D-glucopyranosido-1,6-sorbitol andα-D-glucopyranosido-1,6-mannitol

Management of intracranial hypertension: Recent advances and future directions

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