The Annals of Thoracic Surgery, Vol 40, 16-19, Copyright © 1985 by The Society of Thoracic Surgeons
Effects of prostacyclin infusion on renal function during cardiopulmonary bypass
K Feddersen, C Aren, G Granerus, R Jagenburg and K Radegran
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 less than 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 beta
2-microglobulin in urine. In both groups, urinary beta 2-microglobulin and
the ratio of urinary beta 2- microglobulin to urinary creatinine were
increased the day after operation. The hypotension in Group 1 did not
exacerbate the damage to tubular function.
