Free-Water Clearance and the Early Recognition of Acute Renal Insufficiency after Cardiopulmonary Bypass
The predictive value of free-water clearance measurements for the early recognition of acute renal insufficiency was evaluated in 59 patients immediately following cardiopulmonary bypass. Blood urea nitrogen and serum creatinine measurements were taken before and after operation. Intraoperatively, i...
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| Veröffentlicht in: | The Annals of thoracic surgery 1976-07, Vol.22 (1), p.41-43 |
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| container_title | The Annals of thoracic surgery |
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| creator | Landes, Ronald G. Lillehei, Richard C. Lindsay, William G. Nicoloff, Demetre M. |
| description | The predictive value of free-water clearance measurements for the early recognition of acute renal insufficiency was evaluated in 59 patients immediately following cardiopulmonary bypass. Blood urea nitrogen and serum creatinine measurements were taken before and after operation. Intraoperatively, immediately after completion of bypass, urine and serum samples were obtained for osmolality. Duration of bypass, urine output, degree of hemolysis, and quality of perfusion were recorded. Fifty-four patients developed no signs of renal insufficiency following bypass, and all had free-water clearance values equal to or less than −20 ml per hour. Five patients who had free-water clearance values equal to or greater than −8 ml per hour developed manifestations of an acute renal insufficiency state. There were no false-negative or false-positive determinations.
Consequently, free-water clearance measurements appear to be a reliable indicator of those patients who will develop renal insufficiency following cardiopulmonary bypass. Early recognition provides an opportunity immediately after operation for initiating treatment consisting of administration of diuretics, potassium restriction, and oliguric fluid regimens. |
| doi_str_mv | 10.1016/S0003-4975(10)63950-1 |
| format | Article |
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Consequently, free-water clearance measurements appear to be a reliable indicator of those patients who will develop renal insufficiency following cardiopulmonary bypass. Early recognition provides an opportunity immediately after operation for initiating treatment consisting of administration of diuretics, potassium restriction, and oliguric fluid regimens.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(10)63950-1</identifier><identifier>PMID: 938136</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Acute Kidney Injury - blood ; Acute Kidney Injury - diagnosis ; Blood Urea Nitrogen ; Cardiopulmonary Bypass - adverse effects ; Creatinine - blood ; Diuresis ; Drug Therapy, Combination ; Extracorporeal Circulation - adverse effects ; Female ; Furosemide - therapeutic use ; Glomerular Filtration Rate - drug effects ; Humans ; Kidney - blood supply ; Male ; Postoperative Complications - diagnosis ; Postoperative Complications - mortality ; Regional Blood Flow ; Steroids - therapeutic use ; Urine - analysis ; Water</subject><ispartof>The Annals of thoracic surgery, 1976-07, Vol.22 (1), p.41-43</ispartof><rights>1976 The Society of Thoracic Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-7d82746e6734051c495fcc61aa9ff1507330e146b081b473ec799f72a16be8123</citedby><cites>FETCH-LOGICAL-c459t-7d82746e6734051c495fcc61aa9ff1507330e146b081b473ec799f72a16be8123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/938136$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Landes, Ronald G.</creatorcontrib><creatorcontrib>Lillehei, Richard C.</creatorcontrib><creatorcontrib>Lindsay, William G.</creatorcontrib><creatorcontrib>Nicoloff, Demetre M.</creatorcontrib><title>Free-Water Clearance and the Early Recognition of Acute Renal Insufficiency after Cardiopulmonary Bypass</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>The predictive value of free-water clearance measurements for the early recognition of acute renal insufficiency was evaluated in 59 patients immediately following cardiopulmonary bypass. Blood urea nitrogen and serum creatinine measurements were taken before and after operation. Intraoperatively, immediately after completion of bypass, urine and serum samples were obtained for osmolality. Duration of bypass, urine output, degree of hemolysis, and quality of perfusion were recorded. Fifty-four patients developed no signs of renal insufficiency following bypass, and all had free-water clearance values equal to or less than −20 ml per hour. Five patients who had free-water clearance values equal to or greater than −8 ml per hour developed manifestations of an acute renal insufficiency state. There were no false-negative or false-positive determinations.
Consequently, free-water clearance measurements appear to be a reliable indicator of those patients who will develop renal insufficiency following cardiopulmonary bypass. Early recognition provides an opportunity immediately after operation for initiating treatment consisting of administration of diuretics, potassium restriction, and oliguric fluid regimens.</description><subject>Acute Kidney Injury - blood</subject><subject>Acute Kidney Injury - diagnosis</subject><subject>Blood Urea Nitrogen</subject><subject>Cardiopulmonary Bypass - adverse effects</subject><subject>Creatinine - blood</subject><subject>Diuresis</subject><subject>Drug Therapy, Combination</subject><subject>Extracorporeal Circulation - adverse effects</subject><subject>Female</subject><subject>Furosemide - therapeutic use</subject><subject>Glomerular Filtration Rate - drug effects</subject><subject>Humans</subject><subject>Kidney - blood supply</subject><subject>Male</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - mortality</subject><subject>Regional Blood Flow</subject><subject>Steroids - therapeutic use</subject><subject>Urine - analysis</subject><subject>Water</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1976</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMlOwzAQhi3EVgpvAJJPCA4BO46d-IRKxSYhIbGIo-U6Y2qU2sVOkPr2pIt65TSa-f_ZPoTOKLmihIrrN0IIywpZ8gtKLgWTnGR0Bw0o53kmci530WBrOURHKX33ad7LB2hfsooyMUDT-wiQfeoWIh43oKP2BrD2NW6ngO90bBb4FUz48q51weNg8ch0LfRFrxv85FNnrTMOvFlgbVdjdKxdmHfNLHgdF_h2MdcpHaM9q5sEJ5s4RB_3d-_jx-z55eFpPHrOTMFlm5V1lZeFAFGygnBqCsmtMYJqLa2lnJSMEaCFmJCKToqSgSmltGWuqZhARXM2ROfrufMYfjpIrZq5ZKBptIfQJVWxQlRE0N7I10YTQ0oRrJpHN-sPVpSoJWC1AqyW9JalFWC17DvdLOgmM6i3XWuivXyzlqF_8tdBVGlFB2oXwbSqDu6fBX88uooj</recordid><startdate>197607</startdate><enddate>197607</enddate><creator>Landes, Ronald G.</creator><creator>Lillehei, Richard C.</creator><creator>Lindsay, William G.</creator><creator>Nicoloff, Demetre M.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>197607</creationdate><title>Free-Water Clearance and the Early Recognition of Acute Renal Insufficiency after Cardiopulmonary Bypass</title><author>Landes, Ronald G. ; Lillehei, Richard C. ; Lindsay, William G. ; Nicoloff, Demetre M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c459t-7d82746e6734051c495fcc61aa9ff1507330e146b081b473ec799f72a16be8123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1976</creationdate><topic>Acute Kidney Injury - blood</topic><topic>Acute Kidney Injury - diagnosis</topic><topic>Blood Urea Nitrogen</topic><topic>Cardiopulmonary Bypass - adverse effects</topic><topic>Creatinine - blood</topic><topic>Diuresis</topic><topic>Drug Therapy, Combination</topic><topic>Extracorporeal Circulation - adverse effects</topic><topic>Female</topic><topic>Furosemide - therapeutic use</topic><topic>Glomerular Filtration Rate - drug effects</topic><topic>Humans</topic><topic>Kidney - blood supply</topic><topic>Male</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - mortality</topic><topic>Regional Blood Flow</topic><topic>Steroids - therapeutic use</topic><topic>Urine - analysis</topic><topic>Water</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Landes, Ronald G.</creatorcontrib><creatorcontrib>Lillehei, Richard C.</creatorcontrib><creatorcontrib>Lindsay, William G.</creatorcontrib><creatorcontrib>Nicoloff, Demetre M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Landes, Ronald G.</au><au>Lillehei, Richard C.</au><au>Lindsay, William G.</au><au>Nicoloff, Demetre M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Free-Water Clearance and the Early Recognition of Acute Renal Insufficiency after Cardiopulmonary Bypass</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1976-07</date><risdate>1976</risdate><volume>22</volume><issue>1</issue><spage>41</spage><epage>43</epage><pages>41-43</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>The predictive value of free-water clearance measurements for the early recognition of acute renal insufficiency was evaluated in 59 patients immediately following cardiopulmonary bypass. Blood urea nitrogen and serum creatinine measurements were taken before and after operation. Intraoperatively, immediately after completion of bypass, urine and serum samples were obtained for osmolality. Duration of bypass, urine output, degree of hemolysis, and quality of perfusion were recorded. Fifty-four patients developed no signs of renal insufficiency following bypass, and all had free-water clearance values equal to or less than −20 ml per hour. Five patients who had free-water clearance values equal to or greater than −8 ml per hour developed manifestations of an acute renal insufficiency state. There were no false-negative or false-positive determinations.
Consequently, free-water clearance measurements appear to be a reliable indicator of those patients who will develop renal insufficiency following cardiopulmonary bypass. Early recognition provides an opportunity immediately after operation for initiating treatment consisting of administration of diuretics, potassium restriction, and oliguric fluid regimens.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>938136</pmid><doi>10.1016/S0003-4975(10)63950-1</doi><tpages>3</tpages></addata></record> |
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| ispartof | The Annals of thoracic surgery, 1976-07, Vol.22 (1), p.41-43 |
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| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Acute Kidney Injury - blood Acute Kidney Injury - diagnosis Blood Urea Nitrogen Cardiopulmonary Bypass - adverse effects Creatinine - blood Diuresis Drug Therapy, Combination Extracorporeal Circulation - adverse effects Female Furosemide - therapeutic use Glomerular Filtration Rate - drug effects Humans Kidney - blood supply Male Postoperative Complications - diagnosis Postoperative Complications - mortality Regional Blood Flow Steroids - therapeutic use Urine - analysis Water |
| title | Free-Water Clearance and the Early Recognition of Acute Renal Insufficiency after Cardiopulmonary Bypass |
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