Mannitol-Induced Osmotic Diuresis During Vascular Surgery

Abstract

The surgical therapy of arteriosclerotic aneurysms of the abdominal aorta is now well established. A comparison between mortality statistics of surgically treated cases and those of untreated cases leaves little doubt as to the benefits of operation.^1,2 There has been a progressive reduction in the risk associated with excision of these aneurysms. Occasionally, however, such procedures are followed by oliguria, anuria, and death from acute renal failure. In some centers, it has been reported that renal insufficiency is the major cause of death following resection of abdominal aortic aneurysms. Powers³ found a 30% incidence of oliguria and 4 deaths from distal tubular necrosis during a one-year period in patients in whom the abdominal aorta was crossclamped distal to the renal arteries at one hospital. Others have reported that as many as 20% of deaths following elective resection of abdominal aortic aneurysms could be attributed to acute renal failure.