Renal hypoxanthine balance in cardiac surgery: effects of felodipine |
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Authors: | Jeppsson A Andersson L G Ekroth R Joachimsson P O |
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Institution: | 1. College of Materials Science and Engineering, Chongqing University of Technology, Chongqing, 400054, China;2. Beijing Satellite Manufacturing Factory Co., Ltd, Beijing 100094;4. College of Materials Science and Engineering, Chongqing University, Chongqing 400044, China;2. Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria, Australia;3. Centre of Integrated Critical Care, School of Medicine, University of Melbourne, Melbourne, Victoria, Australia |
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Abstract: | OBJECTIVE: To test the hypothesis that felodipine, a renal vasodilator, can prevent a release of hypoxanthine during rewarming after moderate hypothermic cardiopulmonary bypass and that this is related to improved renal oxygen supply. DESIGN: A prospective, randomized, and controlled study. SETTING: Operating room in the cardiothoracic surgery department of a university hospital. PARTICIPANTS: Twenty-two patients submitted to elective first-time coronary bypass surgery. INTERVENTIONS: A catheter was placed in the left renal vein for thermodilution renal blood flow (RBF) measurement and blood sampling. In 11 patients, felodipine was infused during the hypothermic period of cardiopulmonary bypass. MEASUREMENTS AND MAIN RESULTS: Renal uptake (renal arteriovenous concentration difference x RBF) of hypoxanthine was maintained during rewarming in felodipine-treated patients but not in control patients (55+/-28 v. -39+/-1 nmol/min, p<0.05). Oxygen consumption was higher after felodipine infusion despite unchanged total RBF. A positive correlation between renal oxygen consumption and hypoxanthine uptake and release (r = 0.74, p<0.01) was observed. CONCLUSIONS: Felodipine maintained renal uptake of hypoxanthine during rewarming after hypothermic cardiopulmonary bypass. This maintenance is the effect of improved renal oxygen supply secondary to improved nutritive blood flow at the expense of nonnutritive renal blood flow. |
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Keywords: | cardiac surgery cardiopulmonary bypass renal function felodipine hypoxanthine |
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