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Norepinephrine for hypotensive vasodilatation after cardiac surgery: impact on renal function
Hiroshi Morimatsu1, Shigehiko Uchino, John Chung
1Departments of Intensive Care and Medicine, Austin and Repatriation Medical Centre, Melbourne University, Studley Road, Heidelberg, 3084, Melbourne, Victoria, Australia.
Intensive Care Medicine
|May 23, 2003
Summary
Norepinephrine use after cardiac surgery does not worsen kidney function. This study found no significant increase in serum creatinine levels in patients treated with norepinephrine for hypotension, suggesting safety for renal function.
Area of Science:
- Nephrology
- Cardiology
- Critical Care Medicine
Background:
- Norepinephrine use in post-cardiac surgery patients is debated due to potential renal vasoconstriction.
- Hypotensive vasodilatation is a common complication after cardiac surgery.
Purpose of the Study:
- To investigate the renal effects of norepinephrine in patients experiencing hypotensive vasodilatation post-cardiac surgery.
Main Methods:
- Retrospective controlled study involving 200 cardiac surgery patients (100 norepinephrine group, 100 controls).
- Norepinephrine was administered for mean arterial pressure below 70 mmHg.
- Serum creatinine levels were monitored on postoperative days 0, 2, and 4.
Main Results:
- The norepinephrine group exhibited higher central venous pressure and lower mean arterial pressure, with similar cardiac index compared to controls.
- Despite norepinephrine administration, no significant difference in the change of serum creatinine was observed between groups.
- Peak norepinephrine dosage averaged 7.3+/-6.4 micro g/min.
Conclusions:
- Norepinephrine administration for hypotensive vasodilatation after cardiac surgery does not elevate post-operative serum creatinine.
- Concerns regarding norepinephrine's adverse impact on kidney function in this patient population appear unfounded.