Kimura Shigeyoshi, Ogawa Haruhiko, Katayama Yoichi
Department of Neurological Surgery, Kasukabe Municipal Hospital, 7-2-1 Cyuo, Kasukabe-shi, Saitama 344-8588, Japan.
No Shinkei Geka. 2006 Jan;34(1):51-6.
We experienced a case in which hyperkalemia was induced by mannitol administration. The medication with mannitol was given to a 15-year-old male patient who underwent a removal operation for arteriovenous malformation under general anesthesia. Following the mannitol infusion, his arterial blood gas and electrolyte analysis revealed severe metabolic acidosis and an increase in serum potassium. Furthermore, a change in his electrocardiogram was observed. The hyperkalemia was quickly normalized by medication with calcium gluconate and sodium bicarbonate. We stopped the removal operation with the aim of giving priority to the patient's safety. It is speculated that the hyperkalemia was caused by the administration of mannitol. Checks of electrolyte levels, arterial blood gas analysis and electrocardiogram monitoring should therefore be carried out when using mannitol, especially in an emergency situation such as intracranial hemorrhage.
我们遇到了一例因使用甘露醇导致高钾血症的病例。一名15岁男性患者在全身麻醉下接受动静脉畸形切除手术,术中使用了甘露醇。输注甘露醇后,他的动脉血气和电解质分析显示严重代谢性酸中毒且血清钾升高。此外,观察到他的心电图有变化。通过静脉注射葡萄糖酸钙和碳酸氢钠,高钾血症迅速得到纠正。为了优先保障患者安全,我们停止了切除手术。推测高钾血症是由甘露醇的使用引起的。因此,在使用甘露醇时,尤其是在颅内出血等紧急情况下,应进行电解质水平检查、动脉血气分析和心电图监测。