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Effects of hypertonic mannitol on renal function in open heart surgery
Japanese Heart Journal
|March 1, 1983
Summary
Hypertonic mannitol infusions effectively maintained renal plasma flow and urine volume during extracorporeal bypass in dogs and patients. Mannitol preserved glomerular perfusion, especially at lower arterial pressures, indicating a protective effect on kidney function during bypass.
Area of Science:
- Nephrology
- Cardiovascular Surgery
- Pharmacology
Background:
- Extracorporeal bypass (ECBP) can compromise renal function.
- Hypertonic mannitol is a potential nephroprotective agent during ECBP.
Purpose of the Study:
- To evaluate the effects of hypertonic mannitol on renal function during ECBP in mongrel dogs and human patients.
- To assess mannitol's impact on renal plasma flow (RPF), creatinine clearance (Ccr), and glomerular perfusion under varying arterial pressures.
Main Methods:
- Mongrel dogs underwent 2-hour ECBP with or without hypertonic mannitol infusion.
- Human patients (n=11) undergoing ECBP >2 hours received mannitol infusions.
- Measurements included plasma osmolality, urine volume, Ccr, and glomerular carbon filling rates.
Main Results:
- Mannitol maintained urine volume and RPF during and after ECBP in both dogs and patients.
- Mannitol preserved glomerular perfusion at a mean arterial pressure of 60 mmHg but not 80 mmHg in dogs.
- In patients, Ccr increased initially but then decreased; urine volume significantly increased during bypass.
Conclusions:
- Hypertonic mannitol is effective in maintaining RPF and urine output during and after ECBP.
- Mannitol preserves glomerular perfusion, particularly at lower arterial pressures, offering renal protection during bypass.