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Related Experiment Videos

Acute mannitol intoxication in a patient with normal renal function.

J S Huff1

  • 1Division of Emergency Medicine, Eastern Virginia Graduate School of Medicine, Norfolk.

The American Journal of Emergency Medicine
|July 1, 1990
PubMed
Summary
This summary is machine-generated.

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A patient mistakenly received a large dose of mannitol, leading to intoxication. Early recognition of the abnormal osmolal gap is crucial for proper diagnosis and treatment.

Area of Science:

  • Clinical Toxicology
  • Nephrology
  • Emergency Medicine

Background:

  • Mannitol is a hyperosmolar agent commonly used for managing intracranial pressure.
  • Mistakes in medication dosage can occur, especially in critical care settings.
  • Hyponatremia can be a presenting symptom of osmotic disturbances.

Observation:

  • A young, previously healthy patient with multiple trauma received an accidental overdose of 400 grams of mannitol over 3 hours.
  • The patient presented with laboratory findings of hyponatremia, prompting treatment with hypertonic saline.
  • An osmolal gap of 118 was identified, indicating a significant solute imbalance.

Findings:

  • The patient experienced mannitol intoxication, a rare occurrence in individuals without pre-existing renal failure.

Related Experiment Videos

  • The hyperosmolar state was initially unrecognized, leading to delayed appropriate management.
  • An elevated osmolal gap served as a key indicator of mannitol toxicity.

    • Implications:

    • This case highlights the importance of recognizing the osmolal gap in diagnosing osmotic disturbances.
    • Prompt identification of hyperosmolar states is critical for effective patient management.
    • Clinicians should be vigilant for potential medication errors and their consequences, even in patients without underlying organ dysfunction.