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Pulmonary embolism during mannitol therapy

G S Robinson, W H Wiese

    Chest
    |March 1, 1980
    PubMed

    Insights

    Rapid mannitol infusion may trigger pulmonary embolism in paraplegic patients. The therapy dilated veins, potentially dislodging a pre-existing clot, leading to cardiopulmonary arrest.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Neurology

    Background:

    • Intravenous mannitol is used for managing intracranial pressure.
    • Pulmonary embolism is a serious complication that can lead to cardiopulmonary arrest.

    Observation:

    • A 25-year-old paraplegic woman experienced cardiopulmonary arrest during intravenous mannitol therapy.
    • The event occurred during administration of mannitol, a hyperosmotic agent.

    Findings:

    • A major pulmonary embolism was identified as the cause of cardiopulmonary arrest.
    • The rapid administration of mannitol may have caused venous dilation, leading to the dislodgement of a preexisting clot.

    Implications:

    • Clinicians should consider the potential risk of pulmonary embolism in patients receiving rapid mannitol infusions, especially those with predisposing factors like paralysis.
    • Further research is needed to elucidate the precise mechanism linking mannitol administration to pulmonary embolism.

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