Czupryna et al.
Effect of a single dose of mannitol on hydration status and electrolyte concentrations in patients with tick-borne encephalitis.
J. Internat. Med. Res. 2018, in press., DOI: 10:1177/0300060518790175
Mannitol is used for the treatment of increased intracranial pressure. While some adverse effects of mannitol are well known, little data are available about the impact of a single dose of mannitol on the hydration status and electrolyte balance of the patient. The authors have enrolled 41 hospitalized TBE patients for a clinical study, who received an intravenous dose of 15% mannitol (0.25g/kg). In this study, hyponatriemia was observed in 12.2% of the subjects on the first day of mannitol administration and in 9% to 24% throughout the 7-day period. Hypokalemia was observed in 22% of subjects on the first day, which continuously increased to 52.3%. The fluid/electrolyte supplementation may be of high importance in already dehydrated patients because dehydration and dyselectrolytemia may deteriorate the chemical state of patients. The authors conclude that patients treated with mannitol may need at least 300ml of fluids per dose of mannitol and should be carefully monitored for hyponatriemia and hypokalemia.