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Aprotinin does not impair renal haemodynamics and function after cardiac surgery

Schweizer, A. ; Höhn, L. ; Morel, D R. ; Kalangos, A. ; Licker, M.

In: British journal of anaesthesia, 2000, vol. 84, no. 1, p. 16-22

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    Titre
    • Aprotinin does not impair renal haemodynamics and function after cardiac surgery
    Auteur
    • Schweizer, A.. Division of Anaesthesiology, Hôpital Cantonal Universitaire, Geneve, Switzerland.
    • Höhn, L.. Division of Anaesthesiology, Hôpital Cantonal Universitaire, Geneve, Switzerland.
    • Morel, D R.. Division of Anaesthesiology, Hôpital Cantonal Universitaire, Geneve, Switzerland.
    • Kalangos, A.. Division of Anaesthesiology, Hôpital Cantonal Universitaire, Geneve, Switzerland.
    • Licker, M.. Division of Anaesthesiology, Hôpital Cantonal Universitaire, Geneve, Switzerland.
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:294651
    Summary
    Patients undergoing cardiac surgery with moderate hypothermic cardiopulmonary bypass (CPB) were allocated randomly to receive either saline (control group, n = 29) or a high-dose regimen of aprotinin (aprotinin group, n = 28). In both groups, CPB was associated with similar and transient increases in effective renal plasma flow (+54% in controls and +48% in aprotinin-treated patients) and in fractional excretion of sodium and potassium, but glomerular filtration rate remained unchanged. Plasma and urinary ratios of 6-keto-PGF1 alpha to thromboxane B2 (TxB2) increased significantly, indicating systemic and renal release of vasodilatory prostaglandins. Osmolar clearance correlated with urinary excretion of cyclic GMP (r = 0.79 and 0.86 in the control and aprotinin groups, respectively) and 6-keto-PGF1 alpha (r = 0.63 and 0.69 in the control and aprotinin groups, respectively). Compared with preoperative values, plasma atrial natriuretic peptide increased after weaning from CPB (+71% and +93% in the control and aprotinin groups, respectively). Aprotinin had no apparent adverse effect on renal function and it did not alter mechanisms involving prostanoids and atrial natriuretic peptide during cardiac surgery