Mannitol extravasation during partial nephrectomy leading to forearm compartment syndrome

Area of Science:

• Nephrology
• Urology
• Surgical Complications

Background:

• Mannitol is an osmotic diuretic commonly used during partial nephrectomy.
• Intravenous (IV) catheter integrity is critical for safe drug administration.
• Compartment syndrome is a surgical emergency caused by increased pressure within a fascial compartment.

Observation:

• A case of forearm compartment syndrome occurred following mannitol infusion.
• The complication was associated with the patient's intravenous catheter access.
• The infusion was administered during a partial nephrectomy procedure.

Findings:

• This represents the first documented instance of forearm compartment syndrome linked to mannitol infusion.
• The complication highlights potential risks associated with IV catheter management during osmotic diuresis.
• Early detection and intervention are key to managing compartment syndrome.

Implications:

• Emphasizes the need for meticulous IV catheter monitoring during and after mannitol administration.
• Suggests that healthcare providers should maintain heightened awareness of potential infusion-related complications.
• Prompt diagnosis and surgical decompression can mitigate severe functional deficits and long-term sequelae.