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Ann Thorac Surg 1985;40:16-19
© 1985 The Society of Thoracic Surgeons

Articles

Effects of Prostacyclin Infusion on Renal Function during Cardiopulmonary Bypass

Kurt Feddersen, M.D., Claes Arén, M.D., Göran Granérus, M.D., Rudolf Jagenburg, M.D., Kjell Rådegran, M.D.*

Departments of Thoracic Surgery and Anesthesiology, Sahlgrenska sjukhuset, Göteborg, Sweden

Accepted for publication December 12, 1984.

* Address reprint requests to Dr. Rådegran, Department of Thoracic Surgery, Sahlgrenska sjukhuset, S-413 45 Göteborg, Sweden

Infusion of prostacyclin inhibits platelet activation during cardiopulmonary bypass (CPB) but also results in systemic arterial hypotension. Therefore, the effects of CPB and prostacyclin on renal function were studied in 36 male patients undergoing aortocoronary bypass. Nineteen patients (Group 1) received prostacyclin, 50 ng per kilogram of body weight per minute, during CPB, and 17 patients (Group 2) served as controls. There was pronounced hypotension in Group 1 only. Urine production during CPB averaged 88 ± 140 ml and 2,306 ± 1,112 ml in Groups 1 and 2, respectively. No patient had renal failure. Glomerular filtration rate (GFR), as measured by clearance of chromium 51-labeled ethylenediaminetetraacetic acid, was increased in Group 1 from 86 ± 14 to 99 ± 22 ml/1.73 m2/min (p < 0.05) the day after operation, but remained unchanged in Group 2 (81 ± 15 to 82 ± 21 ml/1.73 m2/min). The increased GFR in Group 1 can be regarded as an expected adaptation to the change in body fluids after CPB. Therefore, the unchanged GFR in Group 2 must be regarded as caused by insufficient adaptation or impaired renal function.

Proximal tubular function was evaluated by determination of β2-microglobulin in urine. In both groups, urinary β2-microglobulin and the ratio of urinary β2-microglobulin to urinary creatinine were increased the day after operation. The hypotension in Group 1 did not exacerbate the damage to tubular function.






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