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Case report Mannitol infusion induced hyperkalemia in brain tumor surgery
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Abstract
Mannitol is the most widely used hyperosmolar agent during neurosurgical procedures. However, the use of Mannitol can lead to serious electrolyte disturbances, especially hyperkalemia.
We report a 58-year-old male patient, who had a history of hypertension and was indicated for brain tumor surgery. The preoperative tests allowed surgery, during the operation, he was infused 250ml of 20% Mannitol for 10 minutes immediately before opening the dura. Fifteen minutes after completion of the Mannitol infusion, hyperkalemia appeared with peaked T waves on the electrocardiogram and the result of an arterial blood gas (ABG) showed a potassium concentration of 6.74mmol/l. He was treated urgently for hyperkalemia with Canxiclorua, rapid Insulin and Furosemide.
After 2 hours, the potassium was tested again at 5.52mmol/l and then surgery ended, he was transferred to the surgical intensive care unit (SICU) and retested ABG, the results of potassium in SICU was 3.2 mmol/l. After 2 weeks of surgery, the patient was discharged from the hospital without any complications.
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Keywords
Brain tumor surgery, Mannitol, hyperkalemia
References
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