Ventricular tachycardia without preceding electrocardiogram change after hypertonic mannitol administration: a case report

摘要

Abstract BackgroundMannitol is widely used during neurosurgery, but it has a serious complication including lethal arrhythmia due to mannitol-induced hyperkalemia.Case presentationWe report on a 62-year-old man scheduled for the clipping of an unruptured cerebral artery aneurysm. During surgery, approximately 20?min after the end of 200-mL 20% hypertonic mannitol administration, ventricular tachycardia (VT) occurred without preceding electrocardiogram (ECG) change, such as peaked T waves, and VT was recovered to sinus rhythm after chest compression. A potassium concentration after recovery from VT was 6.4?mEq/L, which was normalized by the administration of calcium gluconate, furosemide, and insulin with glucose.ConclusionsPhysicians must be aware that VT without preceding ECG change can occur after hypertonic mannitol administration.