The Sound of Evolution
Mannitol
甘露醇
Mechanism of action:
Mannitol 是一種滲透性利尿劑（osmotic diuretic），屬於多元醇類化合物（sugar alcohol/polyol）。Mannitol 靜脈注射後幾乎不會被代謝，主要分布於細胞外液（以血管內為主），使血漿滲透壓上升。由於血漿滲透壓提高，水分會自腦組織、眼球等組織間隙移動至血管內，從而降低腦水腫與顱內壓、眼內壓。Mannitol 可經腎絲球自由過濾，但不被腎小管再吸收，在腎小管腔內維持高滲透壓，阻止水分回流至血液，造成滲透性利尿（osmotic diuresis）。
Reference(s):
1. Cruz J et al. (2001). Improving clinical outcomes from acute subdural hematomas with the emergency preoperative administration of high doses of mannitol: a randomized trial. Neurosurgery.
2. Cruz J et al. (2002). Major clinical and physiological benefits of early high doses of mannitol for intraparenchymal temporal lobe hemorrhages with abnormal pupillary widening: a randomized trial. Neurosurgery.
3. Cruz J et al. (2004). Successful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial. J Neurosurg.