Dangers of Mannitol in Treatment of Reye's Syndrome

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Abstract
To the Editor: The letter by Newman et al.1 in the November 9, 1978, issue of the Journal describes encouraging results obtained with intraventricular monitoring of cerebrospinal-fluid pressure and intermittent intravenous mannitol at doses of 2 g per kilogram every four hours for the management of intracranial hypertension associated with Reye's syndrome. We recently saw a child with this disorder in whom regular treatment with similarly large doses of mannitol produced severe hyperosmolarity, which might have contributed to a fatal outcome.The patient was an 11-year-old girl with a two-day history of vomiting and progressive deterioration in level of consciousness. . . .