Use of mannitol during neurosurgery: interpatient variability in the plasma and CSF levels

An i.v. infusion of mannitol was given over 15 min to 12 patients before they underwent intracranial surgery under general anesthesia. Samples of blood, CSF and urine were taken over 4 h. Mannitol disappeared from plasma in a bi-exponential manner. The mean maximal plasma concentration was 4.08 mg/m...

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Bibliographic Details
Published in:European journal of clinical pharmacology 1988-01, Vol.35 (6), p.643-649
Main Authors: ANDERSON, P, BOREUS, L, GORDON, E, LAGERKRANSER, M, RUDEHILL, A, LINDQUIST, C, OHMAN, G
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Brain - surgery
Cardiovascular system
Female
Gas Chromatography-Mass Spectrometry
Humans
Infusions, Intravenous
Male
Mannitol - blood
Mannitol - cerebrospinal fluid
Mannitol - pharmacokinetics
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Vasodilator agents. Cerebral vasodilators
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Summary:An i.v. infusion of mannitol was given over 15 min to 12 patients before they underwent intracranial surgery under general anesthesia. Samples of blood, CSF and urine were taken over 4 h. Mannitol disappeared from plasma in a bi-exponential manner. The mean maximal plasma concentration was 4.08 mg/ml at 15 min, and at 4 h it had declined to 0.53 mg/ml. The mean distribution rate constant was 11.2 h-1, corresponding to a plasma distribution half-life of 0.11 h. The mean elimination rate constant was 0.41 h-1, the plasma half-life was 2.2 h, the central distribution volume was 16.3 l, and total plasma clearance was 100.4 ml/min. The mean concentration of mannitol in CSF during the 4 h period increased up to 0.10 mg/ml. There were marked interindividual differences in the concentration ratio blood/CSF, and the CSF concentration varied 7.5 fold between patients. Optimal use of mannitol during neurosurgery requires further prolonged study of its pharmacokinetics.
ISSN:0031-6970
1432-1041
DOI:10.1007/BF00637601