マンニトールの投与により高カリウム血症を来した脳動静脈奇形の1例

Hyperkalemia Caused by Intravenous Administration of Mannitol in a Patient with Arteriovenous Malformation : Case Report

Ⅰ．は じ め に

　マンニトールの投与により，血清電解質に変化を来すことが知られているが，血清カリウム値の変動に関して，過去の報告では低下ないしは生理的変動内というものが多く，血清カリウム値の上昇が報告されたものは少ない．われわれは，マンニトール投与後に高カリウム血症を呈した1例を経験したので報告する．

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.