PMID: 11605922Oct 19, 2001Paper

Changes in plasma creatinine concentration after cardiac anesthesia with isoflurane, propofol, or sevoflurane: a randomized clinical trial

Anesthesiology
D A StoryP L McNicol

Abstract

Renal impairment often follows cardiac surgery. The authors investigated whether sevoflurane produces greater increases in plasma creatinine concentration than isoflurane or propofol after elective coronary artery surgery. As part of maintenance anesthesia, including during cardiopulmonary bypass, patients were randomly allocated to receive one of three agents: isoflurane (n = 118), sevoflurane (n = 118), or propofol (n = 118). Fresh gas flows were 3 l/min. The preoperative plasma creatinine concentration was subtracted from the highest creatinine concentration in the first 3 postoperative days. A median maximum increase greater than 44 microM (0.5 mg/dl) was regarded as clinically important. Data were analyzed on an intention-to-treat basis. Subgroup analyses were performed on per-protocol patients and those with preoperative renal impairment (creatinine concentration > 130 microM [1.47 mg/dl] or urea > 7.7 mM [blood urea nitrogen, 21.6 mg/dl]). The differences between the groups were small, clinically unimportant, and not statistically significant for the primary analysis and subgroups. The proportions of patients with creatinine increases greater than 44 microM were 15% in the isoflurane group, 17% in the sevoflurane group, ...Continue Reading

References

Feb 1, 1983·The American Journal of Medicine·S H HouJ T Harrington
Jan 1, 1994·Anesthesia and Analgesia·M KellenR A Thisted
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Citations

Apr 23, 2003·Anesthesia and Analgesia·Duminda N WijeysunderaKeyvan Karkouti
Oct 5, 2006·Current Opinion in Anaesthesiology·Dónall F Cróinín, George D Shorten
Jul 24, 2012·Journal of Cardiothoracic and Vascular Anesthesia·Elena BignamiAlberto Zangrillo
Jan 17, 2014·Kidney International·Young-Chul YooYoung-Lan Kwak
Aug 1, 2014·Kidney International·Lindsey L Huddleston, Kathleen D Liu
Aug 7, 2007·Journal of Cardiothoracic and Vascular Anesthesia·Giovanni LandoniGiorgio Torri
Nov 23, 2011·Acta Anaesthesiologica Scandinavica·E BignamiA Zangrillo
Oct 7, 2006·Journal of Cardiothoracic and Vascular Anesthesia·Suraphong LorsomradeeStefan G De Hert
Sep 15, 2014·The Journal of Thoracic and Cardiovascular Surgery·Jieru CaiXiaoqiang Ding
Dec 4, 2013·Journal of Cardiothoracic and Vascular Anesthesia·Caetano Nigro NetoMaria Angela Tardelli
Sep 6, 2015·Clinical Journal of the American Society of Nephrology : CJASN·Tacyano Tavares LeiteAlexandre Braga Libório
Aug 20, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Rakesh V SondekoppamTimur J-P Özelsel
Oct 8, 2020·Current Opinion in Critical Care·Jean-Maxime CôtéMitchell H Rosner

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