A 70-year-old man with acute intracranial hemorrhage receives intravenous mannitol. Within hours, he develops worsening dyspnea and bibasilar crackles. Vital signs show BP 168/92 mmHg, HR 108/min, RR 24/min, SpO2 88% on room air. Serum creatinine is 3.2 mg/dL (baseline 1.1). Chest X-ray reveals pulmonary edema. He denies chest pain. Which preexisting condition most likely increased the risk of this osmotic nephropathy complication?
- A)Chronic gout
- B)Primary hyperparathyroidism
- C)Chronic hepatitis C infection
- D)Type 1 diabetes mellitus
- E)Congestive heart failureGABARITO
Explicação
Congestive heart failure is correct. Mannitol is an osmotic diuretic that initially expands extracellular volume by drawing water into the intravascular space, which can precipitate pulmonary edema in patients with heart failure. It is useful for lowering intr... Ver explicação completa e trilha adaptativa →