Renal protection in patients undergoing cardiopulmonary bypass with preoperative abnormal renal function

Anesthesia and Analgesia
Guillermo LemaG Meneses

Abstract

We prospectively studied the effects of renal protection intervention in 17 patients with preoperative abnormal renal function (plasma creatinine > 1.5 mg/dL) scheduled for elective coronary surgery. Patients were randomized to either dopamine 2.0 micrograms.kg-1.min-1 (Group 1, n = 10) or perfusion pressure > 70 mm Hg during cardiopulmonary bypass (CPB) (Group 2, n = 7). Glomerular filtration rate and effective renal plasma flow were measured with inulin and 125I-hippuran clearances before the induction of anesthesia, after sternotomy and before CPB, during hypo- and normothermic CPB, after sternal closure, and 1 h postoperatively. Plasma and urine electrolytes were measured, and free water, osmolar, and creatinine clearances, as well as fractional excretion of sodium and potassium, were calculated before and after surgery. Significant differences between groups were found before CPB for glomerular filtration rate (higher in Group 1), urine output (2.0 vs 0.29 mL/min in Group 1 versus Group 2), urinary creatinine (66 vs 175 mg/dL), urinary osmolarity (370 vs 627 mOsm/L), osmolar clearance (2.1 vs 0.7 mL/min), and urinary potassium (33 vs 71 mEq/L). There were no differences between groups during hypo- and normothermic CPB. Aft...Continue Reading

References

Jun 1, 1992·Journal of Cardiothoracic and Vascular Anesthesia·J UrzuaG Meneses
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Citations

Aug 12, 2006·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Guillermo LemaJorge Urzua
May 24, 2001·Progress in Cardiovascular Nursing·S Cope, R Hawley
Apr 12, 2011·Clinical and Experimental Nephrology·Sidharth Kumar SethiAtul Juneja
Jun 25, 2008·The Annals of Thoracic Surgery·Guillermo LemaJorge Urzua
Apr 27, 2010·Acta Anaesthesiologica Scandinavica·G Lema
Dec 8, 2006·Seminars in Dialysis·Swaminathan Karthik, Alan Lisbon
Aug 20, 2008·British Journal of Anaesthesia·G LemaR Canessa
Jun 13, 2002·Anaesthesia·R M HeamesD A Hett

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