Skip to main content

The effect of furosemide on intravascular volume status and electrolytes in patients receiving mannitol: an intraoperative safety analysis.

Publication ,  Journal Article
Bebawy, JF; Ramaiah, VK; Zeeni, C; Hemmer, LB; Koht, A; Gupta, DK
Published in: J Neurosurg Anesthesiol
January 2013

BACKGROUND: Mannitol is often used during intracranial surgery to improve surgical exposure. Furosemide is often added to mannitol to augment this effect. The concern exists, however, that the augmented diuresis caused by the addition of furosemide to mannitol may cause hypovolemia and hypoperfusion, hypokalemia, and hyponatremia. We examined the intraoperative safety of low-dose furosemide (0.3 mg/kg) combined with mannitol (1 g/kg). METHODS: We observed 23 patients in a double-blind, block randomized, placebo-controlled study to examine the effects of furosemide (0.3 mg/kg) when combined with mannitol (1 g/kg) on surgical brain relaxation for tumor surgery. Mannitol and the study drug (furosemide or placebo) were administered, and arterial blood gases with electrolytes (sodium, potassium, and lactic acid) and urine output volume were recorded every 30 minutes for 3 hours. Plasma sodium, potassium, and lactic acid concentrations, and interval urine outputs, were compared across time and between furosemide-placebo assignment groupings, with a P<0.01 considered significant. RESULTS: Although mannitol produced a large volume of diuresis (1533±335 mL), the addition of a low dose of furosemide substantially increased both the rate of production of urine for the first 90 minutes after administration and the total volume of urine produced (2561±611 mL, P<0.001, compared with placebo group). The addition of furosemide did not produce a serum potassium level below 3.8±0.7 mEq/L, a serum sodium level below 128.3±3.4 mEq/L, or a serum lactic acid level above 2.4±0.9 mmol/L. There were no differences in the plasma potassium concentration, sodium concentration, or lactic acid concentration between the drug groups at any time point. CONCLUSIONS: Despite an increase in urine output by as much as 67%, adding low-dose furosemide to mannitol does not seem to produce significant electrolyte derangements or hypovolemia compared with the administration of mannitol alone.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Neurosurg Anesthesiol

DOI

EISSN

1537-1921

Publication Date

January 2013

Volume

25

Issue

1

Start / End Page

51 / 54

Location

United States

Related Subject Headings

  • Urodynamics
  • Plasma Substitutes
  • Patient Safety
  • Neurosurgical Procedures
  • Middle Aged
  • Mannitol
  • Male
  • Lactic Acid
  • Isotonic Solutions
  • Intraoperative Care
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bebawy, J. F., Ramaiah, V. K., Zeeni, C., Hemmer, L. B., Koht, A., & Gupta, D. K. (2013). The effect of furosemide on intravascular volume status and electrolytes in patients receiving mannitol: an intraoperative safety analysis. J Neurosurg Anesthesiol, 25(1), 51–54. https://doi.org/10.1097/ANA.0b013e318269c335
Bebawy, John F., Vijay K. Ramaiah, Carine Zeeni, Laura B. Hemmer, Antoun Koht, and Dhanesh K. Gupta. “The effect of furosemide on intravascular volume status and electrolytes in patients receiving mannitol: an intraoperative safety analysis.J Neurosurg Anesthesiol 25, no. 1 (January 2013): 51–54. https://doi.org/10.1097/ANA.0b013e318269c335.
Bebawy JF, Ramaiah VK, Zeeni C, Hemmer LB, Koht A, Gupta DK. The effect of furosemide on intravascular volume status and electrolytes in patients receiving mannitol: an intraoperative safety analysis. J Neurosurg Anesthesiol. 2013 Jan;25(1):51–4.
Bebawy, John F., et al. “The effect of furosemide on intravascular volume status and electrolytes in patients receiving mannitol: an intraoperative safety analysis.J Neurosurg Anesthesiol, vol. 25, no. 1, Jan. 2013, pp. 51–54. Pubmed, doi:10.1097/ANA.0b013e318269c335.
Bebawy JF, Ramaiah VK, Zeeni C, Hemmer LB, Koht A, Gupta DK. The effect of furosemide on intravascular volume status and electrolytes in patients receiving mannitol: an intraoperative safety analysis. J Neurosurg Anesthesiol. 2013 Jan;25(1):51–54.

Published In

J Neurosurg Anesthesiol

DOI

EISSN

1537-1921

Publication Date

January 2013

Volume

25

Issue

1

Start / End Page

51 / 54

Location

United States

Related Subject Headings

  • Urodynamics
  • Plasma Substitutes
  • Patient Safety
  • Neurosurgical Procedures
  • Middle Aged
  • Mannitol
  • Male
  • Lactic Acid
  • Isotonic Solutions
  • Intraoperative Care