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The influence of mannitol on renal function during and after open-heart surgery

Heart Lung Department, Harefield Hospital, Harefield, Middlesex

P Jones

Heart Lung Department, Harefield Hospital, Harefield, Middlesex

P Barlow

Heart Lung Department, Harefield Hospital, Harefield, Middlesex

S Kennington

Heart Lung Department, Harefield Hospital, Harefield, Middlesex

S Saville

Heart Lung Department, Harefield Hospital, Harefield, Middlesex

J Farrimond

Department of Anaesthetics, Harefield Hospital, Harefield, Middlesex

M Yacoub

Department of Surgery, Harefield Hospital, Harefield, Middlesex

Mannitol is often included in the priming solution of the heart-lung machine used during cardiopulmonary bypass (CPB). This study was set up to evaluate the effect of different doses of mannitol on human patients. Patients receiving 10 g of mannitol (n = 18) had an increased diuresis only during the bypass period (mean time = 87 min) when compared with a control group (n = 19) who did not receive mannitol. Patients receiving 20 g of mannitol (n = 19) had a significantly greater diuresis than both the control group and the 10 g group and the diuresis continued on throughout the immediate postbypass period (total mean time approximately 3 h). Patients receiving 30 g of mannitol (n = 20) also had a significantly greater diuresis that continued on during the first hour in the intensive care unit (ICU) (total mean time approximately 4 h). After 6 h in the ICU, all three groups of mannitol-treated patients equally demonstrated a trend towards an increased diuresis over the control group, which became a significant increase by 12 h in the ICU (p = 0.001) despite indications that the mannitol had been cleared from the body. These results suggest that there is an improvement of renal function post-CPB if mannitol is included in the CPB prime which may be due to an amelioration of the ischaemic effects of bypass on the kidneys.

Perfusion, Vol. 13, No. 3, 181-186 (1998)
DOI: 10.1177/026765919801300305


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