[Blood-level changes of lactate and pyruvate after osmotherapy with mannitol and sorbitol (author's transl)]

In 43 patients osmotherapy with Mannitol 20% and Sorbitol 40% was applied and the changes of the concentrations of lactate and pyruvate were tested in blood. The lactate level of both substances was increased. Sorbitol had the greater effect, and showed its maximum after one hour. For Mannitol the point effect was after four hours. Meanwhile Sorbitol produces an acidosis, the acid-base metabolism is unaffected after Mannitol. The pyruvate-level is not increased significantly, compared with the control group. Therefore the coefficient of lactate to pyruvate is significantly raised. These results highlight the problems of osmotherapy, if the changes of metabolism, induced by the therapy, are not considered. Lactid acidosis, previously existing or a general acidosis, shock, diabetes mellitus and hepatic dysfunctions enhance the risk of osmotherapy especially with Sorbitol.