Renal failure
-
Randomized Controlled Trial Comparative Study
A comparison of the effects of ketamine and remifentanil on renal functions in coronary artery bypass graft surgery.
We have investigated the effects of ketamine-based and remifentanil-based anesthetic protocol on perioperative serum cystatin-C levels, and creatinine and/or cystatin-C-based eGFR equations in terms of acute kidney injury in coronary artery bypass graft (CABG) surgery. Using a simple randomization method (coin tossing), patients were divided into the two groups and not-blinded to the anesthetist. Remifentanil-midazolam-propofol or ketamine-midazolam-propofol-based anesthetic regimen was chosen. ⋯ Reversible stage 1 acute kidney injury (AKI) was observed on postoperative day 2 in seven patients from the remifentanil group and six patients from the ketamine group. Hs-troponin T was found to be higher in postoperative day 1 samples; there were no significant difference between the groups. Our results indicated that patients who have normal renal functions undergoing on-pump coronary bypass surgery, effects of ketamine and remifentanil on renal functions in terms of AKI were found to be similar.
-
Randomized Controlled Trial Clinical Trial
Relationship between the right internal jugular vein and carotid artery at ipsilateral head rotation.
Ultrasound-guided right internal jugular vein catheterization (RIJV) should be the first choice to decrease the catheter-related complications in high-risk hemodialysis patients. For this procedure, clinicians should identify the optimum positions of the RIJV, including its lower overlap with the carotid artery (CA) and high cross-sectional area of the vein. The aim of this prospective randomized study to evaluate the effects of mild ipsilateral head rotation combined with Trendelenburg position on RIJV cross-sectional area and its relation to the CA in adult patients. ⋯ As the head was rotated from >30° left to <30° right, the CA-RIJV overlap (from 95% to 57.5%), and the cross-sectional area (from 14.2 mm to 8.7 mm) significantly decreased. In conclusion, when the head was turned to <30° right, the CA-RIJV overlap significantly decreased, and the cross-sectional area also decreased. When clinicians determine the optimal head position before RIJV cannulation, it is important to consider the advantages and disadvantages of the different head positions from >30° left to <30° right.
-
Randomized Controlled Trial Comparative Study
The effect of HES (130/0.4) usage as the priming solution on renal function in children undergoing cardiac surgery.
Experience with hydroxyethyl starch (HES) in children is limited. This study was conducted to observe the effects of HES or Ringer's lactate (RL) usage as the priming solution on renal functions in children undergoing cardiac surgery. ⋯ We conclude that usage of HES (130/0.4) did not have negative effects on renal function, and it can be used as a priming solution in pediatric patients undergoing cardiac surgery.
-
Randomized Controlled Trial
Prevention of intradialytic hypotension in patients with acute kidney injury submitted to sustained low-efficiency dialysis.
This study evaluated the effects of a protocol aiming to reduce hypotension in acute kidney injury (AKI) patients submitted to sustained low-efficiency dialysis (SLED). ⋯ SLED protocol with modulation of dialysate temperature, sodium, and UF profiling showed similar efficacy but less intradialytic hypotension when compared with a standard SLED prescription.
-
Randomized Controlled Trial
The pharmacodynamics of vecuronium in chronic renal failure patients: the impact of different priming doses.
The concept of priming was introduced to facilitate a faster onset of nondepolarizing neuromuscular blocker for endotracheal intubation. Vecuronium is still very much in use for most chronic renal failure patients posted for renal transplantation. The aim of this study was to examine the pharmacodynamics of vecuronium without and with preceding different small doses. ⋯ Priming the chronic renal failure patients with 10% of ED(95) vecuronium dose acquit the best pharmacodynamics with the fewest signs of muscle weakness. Larger vecuronium priming doses are unfavorable and convey no more clinical utility.