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Low-dose vasopressi...
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Bragadottir, GudrunGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care
(författare)
Low-dose vasopressin increases glomerular filtration rate, but impairs renal oxygenation in post-cardiac surgery patients.
- Artikel/kapitelEngelska2009
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Nummerbeteckningar
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LIBRIS-ID:oai:gup.ub.gu.se/125162
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https://gup.ub.gu.se/publication/125162URI
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https://doi.org/10.1111/j.1399-6576.2009.02037.xDOI
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Klassifikation
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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BACKGROUND: The beneficial effects of vasopressin on diuresis and creatinine clearance have been demonstrated when used as an additional/alternative therapy in catecholamine-dependent vasodilatory shock. A detailed analysis of the effects of vasopressin on renal perfusion, glomerular filtration, excretory function and oxygenation in man is, however, lacking. The objective of this pharmacodynamic study was to evaluate the effects of low to moderate doses of vasopressin on renal blood flow (RBF), glomerular filtration rate (GFR), renal oxygen consumption (RVO2) and renal oxygen extraction (RO2Ex) in post-cardiac surgery patients. METHODS: Twelve patients were studied during sedation and mechanical ventilation after cardiac surgery. Vasopressin was sequentially infused at 1.2, 2.4 and 4.8 U/h. At each infusion rate, systemic haemodynamics were evaluated by a pulmonary artery catheter, and RBF and GFR were measured by the renal vein thermodilution technique and by renal extraction of 51chromium-ethylenediaminetetraacetic acid, respectively. RVO2 and RO2Ex were calculated by arterial and renal vein blood samples. RESULTS: The mean arterial pressure was not affected by vasopressin while cardiac output and heart rate decreased. RBF decreased and GFR, filtration fraction, sodium reabsorption, RVO2, RO2Ex and renal vascular resistance increased dose-dependently with vasopressin. Vasopressin exerted direct antidiuretic and antinatriuretic effects. CONCLUSIONS: Short-term infusion of low to moderate, non-hypertensive doses of vasopressin induced a post-glomerular renal vasoconstriction with a decrease in RBF and an increase in GFR in post-cardiac surgery patients. This was accompanied by an increase in RVO2, as a consequence of the increases in the filtered tubular load of sodium. Finally, vasopressin impaired the renal oxygen demand/supply relationship.
Ämnesord och genrebeteckningar
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MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
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MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
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Anesthesia
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Cardiac Surgical Procedures
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Data Interpretation
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Statistical
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Dose-Response Relationship
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Drug
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Edetic Acid
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Female
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Glomerular Filtration Rate
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drug effects
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Hemodynamics
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drug effects
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Humans
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Kidney
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drug effects
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metabolism
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Kidney Function Tests
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Male
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Middle Aged
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Oxygen Consumption
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drug effects
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Point-of-Care Systems
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Postoperative Period
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Renal Agents
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administration & dosage
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pharmacology
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Renal Circulation
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drug effects
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Thermodilution
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Vasopressins
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administration & dosage
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pharmacology
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Redfors, BengtGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care(Swepub:gu)xredbe
(författare)
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Nygren, Andreas,1967Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care(Swepub:gu)xnygan
(författare)
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Sellgren, Johan,1953Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care(Swepub:gu)xseljo
(författare)
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Ricksten, Sven-Erik,1953Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård,Institute of Clinical Sciences, Department of Anesthesiology and Intensive care(Swepub:gu)xricsv
(författare)
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Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Acta Anaesthesiol Scand: Wiley53:8, s. 1052-91399-6576
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Ingår i:Acta Anaesthesiologica Scandinavica: Wiley53:8, s. 1052-90001-5172
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