Mannitol as Asmotic Diuretic

To the Editor:—  Although there have been references to the use of diuretics for the relief of pulmonary edema,^{1, 2} mannitol has not been specifically indicated as an agent. My own experience with this drug at Sunland Hospital (a 1,000-bed hospital for severely retarded, permanently nonambulatory, and physically handicapped patients) suggests that mannitol may be of significant value in the management of pulmonary edema.I have administered experimentally 100 to 500 ml of mannitol intravenously to 51 patients suffering from preterminal pulmonary edema of various causes. Most interesting and significant were the results in six patients with bronchopneumonia with secondary pulmonary edema that was considered irreversible. In these patients, diuresis began 30 minutes after treatment with mannitol and was followed by a rapid decrease in pulmonary congestion with respiratory exchange improving to such an extent that the patients showed a definite, unexpected recovery.

Report of a Case:—  A 12-year-old