Soliman Rabie, Hussien Mohamed
Department of Cardiac Anesthesia, Madinah Cardiac Center, Almadinah Almonwarah, Saudi Arabia; Department of Cardiac Anesthesia, Cairo University, Giza, Egypt.
Department of Cardiac Surgery, Madinah Cardiac Center, Almadinah Almonwarah, Saudi Arabia.
Ann Card Anaesth. 2017 Oct-Dec;20(4):408-415. doi: 10.4103/aca.ACA_57_17.
The purpose of the current study was to compare the renoprotective effects of continuous infusion of dexmedetomidine and dopamine in high-risk renal patients undergoing cardiac surgery.
A double-blind randomized study.
Cardiac Centers.
One hundred and fifty patients with baseline serum creatinine level ≥1.4 mg/dl were scheduled for cardiac surgery with cardiopulmonary bypass.
The patients were classified into two groups (each = 75): Group Dex - the patients received a continuous infusion of dexmedetomidine 0.4 μg/kg/h without loading dose during the procedure and the first 24 postoperative hours and Group Dopa - the patients received a continuous infusion of dopamine 3 μg/kg/min during the procedure and the first 24 postoperative hours.
The monitors included serum creatinine, creatinine clearance, blood urea nitrogen, and urine output.
The creatinine levels and blood urea nitrogen decreased at days 1, 2, 3, 4, and 5 in Dex group and increased in patients of Dopa group (P < 0.05). The creatinine clearance increased at days 1, 2, 3, 4, and 5 in Dex group and decreased in patients of Dopa group (P < 0.05). The amount of urine output was too much higher in the Dex group than the Dopa group (P < 0.05).
The continuous infusion of dexmedetomidine during cardiac surgery has a renoprotective effect and decreased the deterioration in the renal function in high-risk renal patients compared to the continuous infusion of dopamine.
本研究旨在比较持续输注右美托咪定和多巴胺对心脏手术高危肾患者的肾脏保护作用。
双盲随机研究。
心脏中心。
150例基线血清肌酐水平≥1.4mg/dl的患者计划接受体外循环心脏手术。
患者分为两组（每组75例）：右美托咪定组（Dex组）——患者在手术期间及术后首24小时接受持续输注右美托咪定0.4μg/kg/h，无负荷剂量；多巴胺组（Dopa组）——患者在手术期间及术后首24小时接受持续输注多巴胺3μg/kg/min。
监测指标包括血清肌酐、肌酐清除率、血尿素氮和尿量。
Dex组患者在第1、2、3、4和5天时血清肌酐水平和血尿素氮下降，而Dopa组患者则升高（P<0.05）。Dex组患者在第1、2、3、4和5天时肌酐清除率升高，而Dopa组患者则下降（P<0.05）。Dex组的尿量比Dopa组多得多（P<0.05）。
与持续输注多巴胺相比，心脏手术期间持续输注右美托咪定具有肾脏保护作用，可降低高危肾患者肾功能的恶化。
