Role of dopamine in renal dysfunction during laparoscopic surgery

Pérez, Jaume Llopis; Taurà, Pilar; Rueda, Jose; Balust, Jaume; Anglada, Teresa; Beltrán, Joan; Lacy, Antonio M.; García‐Valdecasas, Juan Carlos

doi:10.1007/s00464-001-9201-8

Cited by 47 publications

(27 citation statements)

References 21 publications

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“…Following a 30-min stabilization period, organs were randomly assigned to one of seven groups (n = 10), where they were exposed to intrachamber pressure of 3,5,8,12,15, or 18 mmHg. The seventh group was perfused under 0 mmHg, serving as pressure control.…”

Section: Isolated Perfused Kidney Preparationmentioning

confidence: 99%

“…Materials and methods Seventy Wistar rat kidneys (n = 10 per group) were isolated. They were perfused with oxygenated, warm, Krebs-Henseleit solution containing 5% albumin within an isolated environment and subjected to various CO 2 pressures (0 [control], 3,5,8,12,15, and 18 mmHg) for 60 min. Half of each group was additionally perfused for 30 min at 0 mmHg pressure.…”

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confidence: 99%

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Renal oxidative stress following CO2 pneumoperitoneum-like conditions

et al. 2008

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Background Physiologic renal changes associated with pneumoperitoneum (PNP) have been described and various underlying mechanisms have been suggested. We investigated the possibility that PNP-associated renal damage is pressure dependent, and that oxidative stress is thereby involved. Materials and methods Seventy Wistar rat kidneys (n = 10 per group) were isolated. They were perfused with oxygenated, warm, Krebs-Henseleit solution containing 5% albumin within an isolated environment and subjected to various CO 2 pressures (0 [control], 3,5,8,12,15, and 18 mmHg) for 60 min. Half of each group was additionally perfused for 30 min at 0 mmHg pressure.Results Renal flow decreased proportionately to the applied pressure as did urine output: both decreased (P \ 0.05) after 60 and 90 min when pressure C8 mmHg was applied. Oxygen extraction decreased (P \ 0.05) during PNP in all pressurized groups. Xanthine oxidase (XO) activity and reduced glutathione in the tissues increased (P \ 0.05) proportionately to pressures C8 mmHg. All parameters slightly reversed toward baseline values, upon the release of the intra-chamber pressure, except for the 18 mmHg group's values. Conclusions CO 2 -PNP pressure induces kidney injury, possibly reversible immediately after pressure is annulled. Pressure is associated with oxidative stress, which interferes with cellular metabolism and function, possibly via an ischemic-reperfusion-like mechanism.

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Section: Isolated Perfused Kidney Preparationmentioning

confidence: 99%

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confidence: 99%

Renal oxidative stress following CO2 pneumoperitoneum-like conditions

et al. 2008

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“…Some previous studies, and even more recent ones, have shown an improvement in renal function in a variety of settings, such as situations of high intra-abdominal pressure during laparoscopy, 23 cardiac surgery, 24,25 refractory ascites due to cirrhosis, 26 liver transplantation, 27 general intensive care 28,29 or postoperative states. Some authors have even suggested that the responsiveness to LDD, as assessed by two-hour creatinine clearance, could be helpful in selecting patients who would benefit from its use.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamics and renal function during administration of low-dose dopamine in severely ill patients

et al. 2004

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CONTEXT: Although a large number of studies have been performed regarding the renal and hemodynamic effects of the infusion of low-dose dopamine (LDD) in severely ill patients, there is still controversy on this subject. OBJECTIVE: To evaluate the effects of dopamine (2 mug/kg/min) on systemic hemodynamics (lowest mean arterial pressure, MAP, highest heart rate, HR, central venous pressure, CVP), creatinine clearance (CLcr), diuresis and fractional sodium excretion (FENa+). TYPE OF STUDY: A non-randomized, open, prospective clinical trial. SETTING: An intensive care unit in a tertiary university hospital. PARTICIPANTS: 22 patients with hemodynamic stability admitted to the intensive care unit. PROCEDURES: Patients were submitted to three two-hour periods: without dopamine (P1), with dopamine (P2) and without dopamine (P3). MAIN MEASUREMENTS: The abovementioned variables were measured during each period. CLcr was assessed based upon the formula U x V/P, where U is urinary creatinine (mg/dl), V is diuresis in ml/min and P is serum creatinine (mg/dl). FENa+ was calculated based upon the formula: urinary sodium (mEq/l) x P/plasma sodium (mEq/l) x U) x 100. Results were presented as mean and standard deviation. The Student t test was used and results were considered significant if p was less than 0.05. RESULTS: Twelve patients (seven males and five females) were included, with a mean age of 55.45 years. There was no significant variation in MAP, HR, CVP, CLcr or FENa+ with a dopamine dose of 2 mug/kg/min. On the other hand, diuresis significantly increased during P2, from 225.4 to 333.9 ml. CONCLUSION: Infusion of 2 mug/kg/min of dopamine for 2 hours increases diuresis. At the doses studied, dopamine does not induce significant alterations in MAP, HR, CVP, CLcr and FENa+.

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“…The use of low dose Dopamine has been recommended earlier based on reported increase of renal perfusion during laparoscopic procedures [26], and has also been suggested in CRS and HIPEC [9,15]. However, the standardized use of furosemide [9] and low dose dopamine [6] is inadvisable as other studies have demonstrated no change in creatinine values during CRS and HIPEC with just maintenance of normovolemia and adequate urine output [2].…”

Section: Cardiovascular Systemmentioning

confidence: 92%

Anaesthetic Considerations in the Perioperative Management of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Sheshadri

Chakravarthy

2016

Indian J Surg Oncol

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Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy has emerged as one of the primary modalities of treatment of diffuse peritoneal malignancies. It is a complex surgical procedure with the patients facing major and potentially life threatening alterations of haemodynamic, respiratory, metabolic and thermal balance with significant fluid losses and the perioperative management is challenging for anaesthesiologists and intensive care physicians. Though the alterations are short lived, these patients require advanced organ function monitoring and support perioperatively. The anaesthesiologist is involved in the management of haemodynamics, respiratory function, coagulation, haematologic parameters, fluid balance, thermal variations, and metabolic and nutritional support perioperatively. The chemotherapy instillate used are known to cause nephrotoxicity, cardiotoxicity, dyselectrolytemia and lactic acidosis. The preoperative polypharmacy for pain control, previous surgery and/or chemotherapy, malnourished status secondary to feeding problems and tumour wasting syndrome make the task all the more challenging. The anaesthesiologist also needs to consider the perioperative care from a quality of life perspective and proper preoperative counselling is important. The present overview summarizes the challenges faced by the anaesthesiologist regarding the pathophysiological alterations during the Cytoreductive surgery and Hyperthermic intraperitoneal chemotherapy in the preoperative, intraoperative and postoperative periods.

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Role of dopamine in renal dysfunction during laparoscopic surgery

Abstract: An intrabdominal pressure of 15 mmHg induces a time-limited renal dysfunction, and low doses of dopamine could prevent this undesirable effect.

Cited by 47 publications

References 21 publications

Renal oxidative stress following CO2 pneumoperitoneum-like conditions

Renal oxidative stress following CO2 pneumoperitoneum-like conditions

Hemodynamics and renal function during administration of low-dose dopamine in severely ill patients

Anaesthetic Considerations in the Perioperative Management of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

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