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[Renal functions and extracorporeal circulation].

A Larcan, M Boulangé, C Fontenaille

    Pathologie-Biologie
    |January 1, 1975
    PubMed
    Summary
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    This study on extracorporeal circulation (CEC) during open heart surgery reveals reduced kidney function, including filtration and perfusion. Despite increased urine output, renal blood flow decreases, potentially leading to temporary kidney problems.

    Area of Science:

    • Nephrology
    • Cardiovascular Surgery
    • Anesthesiology

    Context:

    • Extracorporeal circulation (CEC) is a critical support during open-heart surgery.
    • Renal function monitoring is essential due to potential complications.
    • Understanding renal hemodynamics during CEC is vital for patient outcomes.

    Purpose:

    • To evaluate renal function changes during and after extracorporeal circulation in open-heart surgery.
    • To analyze glomerular filtration, renal perfusion, and blood flow dynamics.
    • To investigate the impact of CEC on renal hemodynamics and electrolyte balance.

    Summary:

    • During 76 open-heart surgeries, renal function tests were conducted throughout the extracorporeal circulation (CEC) period.
    • Observations included reduced thiosulphate and creatinine clearance (glomerular filtration) and PAH clearance (renal perfusion).

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  • Renal blood flow decreased, intrarenal resistances increased, and despite increased diuresis, transient renal hypofunction occurred.

    • Impact:

    • The findings highlight the precariousness of renal perfusion during CEC, often imperfectly compensated by osmotic diuresis.
    • This can lead to transient, reversible renal hypofunction, with potential for organic renal failure in complicated cases.
    • Results emphasize the need for careful management of renal function during and after cardiac surgery involving CEC.