The effects of mannitol on blood viscosity

Allan M. Burke M.D. 1 , Donald O. Quest M.D. 1 , Shu Chien M.D., Ph.D. 1 , and Cesare Cerri M.D. 1
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  • 1 Departments of Neurological Surgery, Neurology, and Physiology, Columbia University, New York, New York
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✓ To determine the effect of mannitol on blood viscosity, serial measurements were carried out on venous blood in patients undergoing craniotomies for intracranial aneurysms. Blood samples were drawn immediately prior to, and 30 minutes, 2, and 4 hours after administration of mannitol. Complete blood counts, serum osmolarities, and erythrocyte microsieving studies were also performed on each sample. Wholeblood viscosity decreased at 30 minutes and 2 hours, but not at 4 hours after mannitol administration. This decrease appeared at high shear rates only, where erythrocyte deformability is critical in determining viscosity. This effect was independent of the hematocrit. Removal of mannitol from the suspension returned red cell deformability to preadministration values, indicating that the increased erythrocyte deformability required the presence of mannitol and the relative hyperosmolarity induced by this agent. The reduced erythrocyte rigidity and subsequent decreased whole-blood viscosity should enhance tissue perfusion in the microcirculation.

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Contributor Notes

Address reprint requests to: Donald O. Quest, M.D., Neurological Institute, 710 West 168th Street, New York, New York 10032.
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