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The Effect of Infusion of Mannitol-Sodium Bicarbonate on the Clinical Course of Myoglobinuria
Judson F. Eneas, MD;
Patricia Y. Schoenfeld, MD;
Michael H. Humphreys, MD
Arch Intern Med. 1979;139(7):801-805.
Abstract
Twenty patients who had evidence of myoglobinuria were treated with intravenous infusions of mannitol and sodium bicarbonate. Nine patients (group 1) responded with higher urine output, and continued infusion improved renal function; none required dialysis and all survived. Eleven patients (group 2) did not respond to the infusion, and required an average of 5.3 (range, 0 to 11) dialyses; one patient died. There was no significant difference in initial BUN level, creatinine level, BUN/ creatinine ratio, or fractional sodium excretion level between the two groups. However, group 2 patients had a significantly higher creatine phosphokinase (CPK) level, serum phosphate level, and hematocrit reading initially than did group 1, indicative of more severe muscle injury and hemoconcentration. These results demonstrate that some patients with myoglobinuria will respond to infusion of mannitol and sodium bicarbonate. This treatment may be effective in altering the clinical course of myoglobinuric acute renal failure.
(Arch Intern Med 139:801-805, 1979)
Author Affiliations
From the University of California Renal Center at San Francisco General Hospital and the Department of Medicine, University of California Medical Center, San Francisco.
Footnotes
Accepted for publication Jan 29, 1979.
Reprint requests to the University of California Renal Center, San Francisco General Hospital, Bldg 100, Room 350, San Francisco, CA 94110 (Dr Humphreys).
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