Use as a diagnostic aid in measurement of glomerular filtration rate.
c. Usual Dosage. The dose of Mannitol varies with the clinical condition being
treated and client response.
(1) Hemolytic transfusion reactions. Twenty-five grams are given IV over a
five-minute period as soon as a reaction occurs or is suspected. Additional IV fluids
should be administered to maintain urine flow at 100-ml/hr. Strict intake and output
records should be maintained on the client. If urine output falls below 100-ml/hr, the
initial dose of Mannitol may be repeated, but not more than 100-grams per 24 hrs.
(2) Urinary excretion of toxic substances. The passive reabsorption of toxic
substances at the proximal tubule can be partially restricted by decreasing the amount
of water reabsorbed at that site. An initial loading dose of 25- to 50-grams of Mannitol
followed by 10 to 20 grams per hour will produce urine volumes of up to 1000 ml/hr.
Fluids and electrolytes must be replaced in the client during this procedure. The
effectiveness of Mannitol in increasing renal excretion of glutethimide, meprobamate,
barbiturates, and salicylates has been demonstrated. It is potentially useful for all
ultrafiltered poisons, which are passively reabsorbed in the proximal tubule.
(3) Test for oliguria. A test dose of 12.5-grams is administered IV over a
period of 3 to 5 minutes. If urine output does not increase to 40 to 60-ml/hour over the
next three hours, the condition is unresponsive to Mannitol. If a response is obtained,
Mannitol should be given by IV infusion to maintain a urine output of 100-ml/hr.
d. Cautions and Warnings.
(1) Mannitol should be administered slowly to avoid sudden increase in
plasma volume and dilutional hyponatremia.
(2) The client's fluid and electrolyte balance should be monitored and
(3) Mannitol should not be mixed with blood in a transfusion set, as
increased osmotic pressure may cause agglutination.
(4) The solution should be checked before administration for crystals.
Directions for putting the crystals back into solution are on the bottle.
(5) Mannitol should be used with great caution in clients having congestive
heart failure and renal insufficiency. It may cause increased congestion or pulmonary
e. Adverse Reactions. Transient headache, nausea, chills, thirst, and pain in
the chest may occur during administration.