Blanloeil Y, Vincent C, Train M, Lepage J Y, Dixneuf B, Dupon H
Cah Anesthesiol. 1984 Oct;32(6):489-94.
Acute renal failure occurred in 21 patients after 311 cardiac operations with cardiopulmonary bypass in adults (6,75%). It was non oliguric in 20 cases. It is related to per and postoperative hemodynamic depression. Patients operated for valvular replacement seemed most at risk if severe cardiac failure existed with or without preoperative renal dysfunction. Similarly those operated upon for mechanical complications of myocardial infarction were often affected. The prognosis depends on the degree of cardiac failure. Strict patient selection, myocardial protection during bypass and measures to increase low cardiac output are recommended. Intra-aortic balloon pump for patients with myocardial infarction and dopamine in the early postoperative period seem helpful.
在311例成人体外循环心脏手术后，21例（6.75%）发生急性肾衰竭。其中20例为非少尿型。这与术中和术后血流动力学抑制有关。如果存在严重心力衰竭且有或无术前肾功能不全，接受瓣膜置换手术的患者似乎风险最高。同样，因心肌梗死机械并发症接受手术的患者也常受影响。预后取决于心力衰竭的程度。建议严格选择患者、体外循环期间进行心肌保护以及采取措施增加低心排血量。对心肌梗死患者使用主动脉内球囊反搏以及术后早期使用多巴胺似乎有帮助。
