【Chelsea Chen】評論

特別容易爆腎的病人才需要mannitolMannitol is frequently used to induce diuresis, although there is no evidence that this is required. It may be appropriate in select patients, such as those treated with high-dose cisplatin (≥100 mg/m2) and/or those with preexisting hypertension. The addition of furosemide is generally not required, unless there is evidence of fluid overload.UpToDate Cisplatin nephrotoxicity

【蓉】評論

●治療前的水化作用：病人在投與cisplatin前和投與後24小時必須適當的補充水分以確信由尿道排出良好並減少腎毒性。水化作用以I.V.輸注2公升的normal saline或glucose-saline(即glucose 4%在1/5 normal saline中)兩者之一，輸注2小時以上。當最後30分鐘的治療前水化作用或水化之後，可由旁滴入37.5g的mannitol。●治療後水化作用：輸注後要適宜的水化作用和尿管排出維持24小時之久。建議治療後I.V.輸注2公升的normal saline或glucose-saline水化作用時間達6-12小時。Ref: 西伯拉丁注射液 Cisplatin Injection "DBL"仿單http://www.ktgh.com.tw/Public/tbDrug/201707211601115334.pdf