Effects of prostaglandin E_1 and low dose dopamine on renal function in patients undergoing orthotopic liver transplantation
- VernacularTitle:前列腺素E_1与多巴胺对肝移植术患者术中肾功能的影响
- Author:
Huan ZHANG
;
Qing QIAO
;
Baxian YANG
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Kidney function tests;
Alprostadil;
Dopamine
- From:
Chinese Journal of Anesthesiology
1994;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of prostaglandin E1 (PGE1) and low-dose dopamine on renal function during orthotopic liver transplantation (OLT) .Methods Eighteen ASA Ⅲ-Ⅳ patients with end-stage liver diseases undergoing OLT were randomly divided into two groups of 9 patients each : PGE1 group (group P) and low-dose dopamine group (group D). Anesthesia was induced with midazolam 0.1-0.2 mg?kg-1 , fentanyl 5 ?g?kg-1 and pipecuronium 0.1 mg?kg1 and maintained with isoflurane inhalation and intermittent i.v. boluses of fentanyi and pipecuronium. The patients were mechanically ventilated after tracheal intubation. PGE1 was infused at 0.4-0.8?g? kg-1 ? h-1 in group P and dopamine at 1 -3 ?g ? kg-1? min in group D after induction until the end of operation. Swan-Ganz catheter was inserted via right internal jugular vein or subclavian vein and radial artery was cannulated. MAP, ECG, CVP, SvO2 , cardiac output ( CO), SpO2 , PET CO2 and core temperature were continuously monitored during operation. Venous blood samples were taken and urine was collected before induction of anesthesia (T1 .baseline), during preanhepatic (T2) anhepatic (T3) and neohepatic phases (T4) and at the end of operation (T5) for determination of serum creatinine (Cr) concentration and serum and urine concentration of ?2 -microglobulin (?2-MG). Creatinine clearance ratio (CCr) was calculated. Total urine output during operation and urine output and the amount of furosemide given during anhepatic phase were recorded. Core body temperature was maintained above 35.5℃ during operation. Veno-venous bypass (VVB) was performed during anhepatic phase.Results In group P, compared to baseline there were no significant changes in MAP, Cr and CCr duringoperation, while serum ?2-MG decreased significantly at T5 and urine ?2-MG increased significantly at T3-5 . In group D serum ?2-MG was significantly decreased while urine ?2 -MG significantly increased at T2.5 compared to baseline. There was significantly more urine output during anhepatic phase and the whole operation and less furosemide was given in group D than in group P. Conclusion Low dose dopamine is more effective in protecting renal function during OLT than PGE1 .
