IMPACT ОF TARGETED THERAPY WITH VARIOUS TYPES ОF SOLUTIONS ON RENAL FUNCTIONS IN THE PATIENTS UNDERGOING CARDIAC SURGERY
https://doi.org/10.21292/2078-5658-2016-13-1-3-10
Abstract
The article describes the impact of the targeted therapy with colloid and crystalloid infusion solutions on renal function and fluid balance during the surgery and early post-surgery period in the patients who underwent aortocoronary bypass under cardio-pulmonary bypass. No differences have been found in the frequency of acute renal lesion as per AKI and the need in the substitution renal therapy. During one stage of the study the lower rates of urine neutrophil gelatinase-associated lipocalin have been observed in the group of crystalloids. The lack of confident differences in the clinical course of the post-surgery period makes the use of the balanced crystalloid solution more preferable compared to colloid solutions.
About the Authors
G. V. Moroz
Е. N. Meshalkin Research Institute o f Blood Circulation Pathology. Novosibirsk
Russian Federation
Russian Federation
E. V. Fominski
Е. N. Meshalkin Research Institute o f Blood Circulation Pathology. Novosibirsk
Russian Federation
Russian Federation
A. N. Shilova
Е. N. Meshalkin Research Institute o f Blood Circulation Pathology. Novosibirsk
Russian Federation
Russian Federation
V. A. Shmyrev
Е. N. Meshalkin Research Institute o f Blood Circulation Pathology. Novosibirsk
Russian Federation
Russian Federation
D. G. Shakhin
St. Petersburg Mutli-Purpose Center, St. Petersburg
Russian Federation
Russian Federation
V. V. Lomivorotov
Е. N. Meshalkin Research Institute o f Blood Circulation Pathology. Novosibirsk
Russian Federation
Russian Federation
References
1. Barbut D., Hinton R. B., Szatrowski T. P. et al. Cerebral emboli detected during bypass surgery are associated with clamp removal//Stroke. -1994. -Vol. 25. -P. 2398-2402.
2. Blauth J. Macroemboli and microemboli during cardiopulmonary bypass//Ann. Thorac. Surg. -1995. -Vol. 59. -P. 1300-1303.
3. Boldt J., Lenz M., Kumle et al. Volume replacement strategies on intensive care units: results from a postal survey//Intens. Care Med. -1998. -Vol. 24, Issue 2. -P. 147-151.
4. Cittanova M. L., Leblanc I., Legendre C. et al. Effect of hydroxyethyl starch in brain-dead kidney donors on renal function in kidney-transplant recipients//Lancet. -1996. -Vol. 348. -P. 1620-1622.
5. Dickenmann M., Oettl T., Mihatsch M. J. Osmotic nephrosis: acute kidney injury with accumulation of proximal tubular lysosomes due to administration of exogenous solutes//Am. J. Kidney Dis. -2008. -Vol. 51, № 3. -P. 491-503.
6. Elgebaly S. A., Houser S. L., Kerm A. F. et al. Evidence of cardiac inflammation after open heart operations//Ann. Thorac. Surg. -1994. -Vol. 57, № 2. -P. 391-396.
7. Hobson C. E., Yavas S., Segal M. S. Acute kidney injury is associated with increased long-term mortality after cardiothoracic surgery//Circulation. -2009. -Vol. 119. -P. 2444-2453.
8. Holmes J. H., Connolly N. C., Paull D. L. et al. Magnitude of the inflammatory response to cardiopulmonary bypass and its relation to adverse clinical outcomes//Inflamm Res. -2002. -Vol. 51, № 12. -P. 579-586.
9. Karkouti K., Wijeysundera D. N., Yau T. M. et al. Acute kidney injury after cardiac surgery: focus on modifiable risk factors//Circulation. -2009. -Vol. 119. -P. 495-502.
10. Lang K., Boldt J., Suttner S. et al. Colloids versus crystalloids and tissue oxygen tension in patients undergoing major abdominal surgery retracted//Analgesia. -2001 -Vol. 93, Is. 2. -P. 405-409.
11. Linden J., Casimir-Ahn H. When do cerebral emboli appear during open heart operations? A transcranial doppler study//Ann. Thorac. Surg. -1991. -Vol. 51. -P. 237-241.
12. Makris K., Markou N., Evodia E. et al. Urinary neutrophil gelatinase-associated lipocalin (NGAL) as an early marker of acute kidney injury in critically ill multiple trauma patients//Clin. Chem. Lab. Med. -2009. -Vol. 47, № 1. -P. 79-82.
13. McCluskey S. A., Karkouti K., Wijeysundera D. et al. Hyperchloremia after noncardiac surgery is independently associated with increased morbidity and mortality: a propensity-matched cohort study//Anesth. Analg. -2013. -Vol. 117, № 2. -P. 412-421.
14. Mishra J., Dent C., Tarabishi R. et al. Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery//Lancet. -2005. -Vol. 365, Is. 9466. -P. 1231-1238.
15. Moat N. E., Evans T. E., Quinlan G. J. et al. Chelatable iron and copper can be released from extracorporeally circulated blood during cardiopulmonary bypass//Fed. Eur. Biochem. Soc. -1993. -Vol. 328. -P. 103-106.
16. Moore E. M., Simpson J. A., Tobin A. et al. Preoperative estimated glomerular filtration rate and RIFLE-classified postoperative acute kidney injury predict length of stay postcoronary bypass surgery in an Australian setting//Anaesth. Intens. Care -2010. -Vol. 38. -P. 113-121.
17. Okusa M. D. The inflammatory cascade in acute ischemic renal failure//Nephron. -2002. -Vol. 90. -P. 133-138.
18. Parikh C. R., Mishra J., Thiessen-Philbrook H. et al. Urinary IL-18 is an early predictive biomarker of acute kidney injury after cardiac surgery//Kidney International. -2006. -Vol. 70. -P. 199-203.
19. Perel P., Roberts I., Pearson M. Cochrane Injuries Group. Colloids versus crystalloids for fluid resuscitation in critically ill patients (Review) London School of Hygiene & Tropical Medicine, London, UK. -2009.
20. Perner A., Haase N., Guttormsen A. B. et al. 6S Trial Group; Scandinavian Critical Care Trials Group Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis//N. Engl. J. Med. -2012. -Vol. 367, № 2. -P. 124-134.
21. Quilley C. P., Lin Y. S, McGiff J. C. Chloride anion concentration as a determinant of renal vascular responsiveness to vasoconstrictor agents//Br. J. Pharmacol. -1993. -Vol. 108. -P. 106-110.
22. Rosner M. H., Okusa M. D. Acute kidney injury associated with cardiac surgery//CJASN. -2006. -Vol. 1, № 1. -P. 19-32.
23. Shaw A. D., Bagshaw S. M., Goldstein S. L. et al. Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to Plasma-Lyte//Ann. Surg. -2012. -Vol. 255, № 5. -P. 821-829.
24. Sreeram G. M., Grocott H. P., White W. D. et al. Transcranial doppler emboli count predicts rise in creatinine after coronary artery bypass graft surgery//J. Cardiovasc. Vasc. Anesth. -2004. -Vol. 18. -P. 548-551.
25. Vincent J. L. Fluid resuscitation: colloids vs crystalloids//Acta. Clin. Belg. Suppl. -2007. -Vol. 2. -P. 408-411.
26. Wilcox C. S. Regulation of renal blood flow by plasma chloride//J. Clin. Invest. -1983. -Vol. 71. -P. 726-735.
27. Wilkes M. M., Navickis R. J., Sibbald W. J. Albumin versus hydroxyethyl starch in cardiopulmonary bypass surgery: a meta-analysis of postoperative bleeding//Ann. Thorac. Surg. -2001. -Vol. 72, № 2. -P. 527-533.
Review
For citations:
Moroz G.V., Fominski E.V., Shilova A.N., Shmyrev V.A., Shakhin D.G., Lomivorotov V.V. IMPACT ОF TARGETED THERAPY WITH VARIOUS TYPES ОF SOLUTIONS ON RENAL FUNCTIONS IN THE PATIENTS UNDERGOING CARDIAC SURGERY. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2016;13(1):3-10. (In Russ.) https://doi.org/10.21292/2078-5658-2016-13-1-3-10
Email this article 