Mannitol and cardiac surgery

Mannitol is widely used in all fields of medicine, due to its beneficial ac tions on the kidney and brain. Mannitol has been extensively used in cardia c surgery since its infancy, and remains in common usage to day. Mannitol i s mainly used for its effects on the kidneys, but it has actions on the bra in, lungs, heart, gastrointestinal tract and the red cell. Mannitol also ha s effects on free radicals and nitric oxide. As with virtually all treatmen ts in medicine and surgery its use is not immune from side effects. The med ical literature on mannitol over the past 30 years is considered.