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

Simple item page
dc.contributor.authorLema, G
dc.contributor.authorUrzua, J
dc.contributor.authorJalil, R
dc.contributor.authorCanessa, R
dc.contributor.authorMoran, S
dc.contributor.authorSacco, C
dc.contributor.authorMedel, J
dc.contributor.authorIrarrazaval, M
dc.contributor.authorZalaquett, R
dc.contributor.authorFajardo, C
dc.contributor.authorMeneses, G
dc.date.accessioned2024-01-10T14:21:33Z
dc.date.available2024-01-10T14:21:33Z
dc.date.issued1998
dc.description.abstractWe 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 ,mu g.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 I-125-hippuran clearances before the induction of anesthesia, after sternotomy and before CFB, 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 ed 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. After CPB, the only difference was a slightly higher urinary creatinine in Group 2. Renal plasma flow was lower than normal in all patients before the induction of anesthesia. A nonsignificant trend toward increased flow was seen during hypothermic CPB. Filtration fraction was high before CPB, which suggests efferent arteriolar vasoconstriction, descending toward normal during and after CPB. The same pattern of changes was present in both groups. In conclusion, there were no clinically relevant differences between the two treatment modalities during and after CPB. However, significant differences were observed before CPB, when dopamine seemed to partially revert renal vasoconstriction. Implications: Two protective interventions were compared in patients undergoing heart surgery to prevent deterioration of renal function; these were dopamine infusion throughout the operation and phenylephrine infusion during cardiopulmonary bypass. We found clinically relevant differences only during surgery before cardiopulmonary bypass.
dc.fechaingreso.objetodigital2024-05-15
dc.format.extent6 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1097/00000539-199801000-00002
dc.identifier.issn0003-2999
dc.identifier.pubmedidMEDLINE:9428842
dc.identifier.urihttps://doi.org/10.1097/00000539-199801000-00002
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/79705
dc.identifier.wosidWOS:000071155100002
dc.information.autorucMedicina;Canessa R;S/I;55800
dc.information.autorucMedicina;Irarrázaval M;S/I;98706
dc.information.autorucMedicina;Lema G;S/I;99835
dc.information.autorucMedicina;Urzúa J;S/I;98495
dc.information.autorucMedicina;Zalaquett R;S/I;100042
dc.issue.numero1
dc.language.isoen
dc.nota.accesoSin adjunto
dc.pagina.final8
dc.pagina.inicio3
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.revistaANESTHESIA AND ANALGESIA
dc.rightsregistro bibliográfico
dc.subjectCORONARY-ARTERY BYPASS
dc.subjectCARDIAC-SURGERY
dc.subjectDOSE DOPAMINE
dc.subjectPRESSURE
dc.subjectTRIAL
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleRenal protection in patients undergoing cardiopulmonary bypass with preoperative abnormal renal function
dc.typeartículo
dc.volumen86
sipa.codpersvinculados55800
sipa.codpersvinculados98706
sipa.codpersvinculados99835
sipa.codpersvinculados98495
sipa.codpersvinculados100042
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Renal Protection in Patients Undergoing Cardiopulmonary Bypass with Preoperative Abnormal Renal Function.pdf
Size:
103.83 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Artículos de revistas