Low-dose prostacyclin preserves renal function in high-risk patients after coronary bypass surgery

Critical Care Medicine
Stanislao MorgeraHans-Hellmut Neumayer

Abstract

Renal failure after bypass is still a threatening problem prolonging hospital care and reducing overall survival. The following pilot study was aimed to analyze whether perioperative low-dose prostacyclin infusion is able to preserve renal function in a selected group of patients who according to a poor cardiac function were stratified as high risk for the development of renal failure after bypass. Prospective randomized study. Tertiary care university medical center. Thirty-four patients scheduled for primary cardiac bypass surgery were included in the study (prostacyclin n = 17, control n = 17). Inclusion criteria were normal renal function before surgery and a cardiac ejection fraction <40%. Low-dose prostacyclin (2 ng/kg/min) was added to the standard anesthetic protocol. Infusion was started immediately before surgery and was continued for a maximum of 48 Significant differences in the endogenous creatinine clearance were found between the prostacyclin and the control group. Whereas there was a significant drop in the creatinine clearance at 6 hrs after surgery in the control group with a prolonged recovery period, values in the prostacyclin group remained stable. Creatinine clearance before intervention was 100 +/- 22 mL/...Continue Reading

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Dec 4, 2008·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Finola NaughtonW Scott Beattie
Feb 6, 2004·Best Practice & Research. Clinical Anaesthesiology·Ignatius Y Tang, Patrick T Murray
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