A 73-year-old man with a large intracerebral hemorrhage (CT head shows 40-mL hematoma) is given mannitol to rapidly decrease intracranial pressure. Currently, BP 165/95 mmHg, HR 98/min, RR 22/min, SpO2 88% on room air. He soon develops dyspnea with bibasilar crackles on auscultation. Chest X-ray shows pulmonary edema. He denies orthopnea. Which comorbid condition most strongly predisposed him to this complication?
- A)Heart failureGABARITO
- B)Gout
- C)Benign prostatic hyperplasia
- D)Addison disease
- E)Closed angle glaucoma
Explicação
Mannitol increases plasma osmolality and initially draws water into the intravascular space before it is excreted. In patients with heart failure, this transient volume expansion can precipitate pulmonary edema and worsening respiratory status. Ver explicação completa e trilha adaptativa →