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

Abstract

Abstract Background Mannitol is widely used during neurosurgery, but it has a serious complication including lethal arrhythmia due to mannitol-induced hyperkalemia. Case presentation We 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. Conclusions Physicians must be aware that VT without preceding ECG change can occur after hypertonic mannitol administration.

Keywords

• Mannitol
• Hyperkalemia
• Lethal arrhythmia
• Ventricular tachycardia