Kinoshita Y, Yahata K, Yoshioka T, Onishi S, Sugimoto T
Department of Traumatology and Emergency Medicine, Osaka University Hospital, Japan.
Transpl Int. 1990 May;3(1):15-8. doi: 10.1007/BF00333196.
In order to examine renal function after brain death, twenty-eight patients were randomly separated into two groups. The systemic blood pressure of ten patients was maintained with epinephrine alone (group 1). Eight of the ten patients experienced cardiac arrest within 48 h (range 6-87 h) despite the rather large dosage of epinephrine. Urine output was uncontrollable and renal function deteriorated progressively in this group. Eighteen patients were maintained with arginine vasopressin and epinephrine (group 2). Circulation was maintained with a smaller dosage of epinephrine than that given group 1 for at least 4 days (mean +/- SD 16.5 +/- 12.2 days). Urine output was controlled within the normal range and serum levels of blood urea nitrogen (BUN) and creatinine were normal for 14 days. Daily creatinine clearance was more than 80 ml/min. The combined administration of arginine vasopressin and epinephrine preserved the kidneys after brain death for more than a week. This method will be of great value in renal transplantation from brain-dead organ donors.
为了研究脑死亡后的肾功能，28例患者被随机分为两组。10例患者仅用肾上腺素维持全身血压（第1组）。尽管使用了相当大剂量的肾上腺素，但这10例患者中有8例在48小时内（6 - 87小时）发生心脏骤停。该组尿量无法控制，肾功能逐渐恶化。18例患者用精氨酸加压素和肾上腺素维持（第2组）。维持循环所需的肾上腺素剂量比第1组小，且至少维持4天（平均±标准差16.5±12.2天）。尿量控制在正常范围内，血尿素氮（BUN）和肌酐的血清水平在14天内正常。每日肌酐清除率超过80 ml/分钟。精氨酸加压素和肾上腺素联合应用在脑死亡后使肾脏功能维持了一周以上。这种方法在脑死亡器官供体的肾移植中具有重要价值。
