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Intensive Care Medicine

Published in:

01-07-2003 | Original

Norepinephrine for hypotensive vasodilatation after cardiac surgery: impact on renal function

Authors: Hiroshi Morimatsu, Shigehiko Uchino, John Chung, Rinaldo Bellomo, Jai Raman, Brian Buxton

Published in: Intensive Care Medicine | Issue 7/2003

Abstract

Objectives

Norepinephrine use in patients after cardiac surgery is controversial because of the fear that norepinephrine might decrease kidney function through regional vasoconstriction. Accordingly, we studied the renal effects of norepinephrine use for hypotensive vasodilatation after cardiac surgery.

Design and setting

Retrospective controlled study in the cardiothoracic ICU of tertiary hospital.

Patients

100 cardiac surgery patients with post-operative hypotensive vasodilatation and 100 control cardiac surgery patients.

Intervention

Treatment of hypotension (MAP<70 mmHg) with continuous norepinephrine infusion.

Measurements and results

We collected data on demographic and surgical characteristics, haemodynamics, serum creatinine and mortality. Just after surgery the norepinephrine group had a significantly higher mean central venous pressure, lower mean arterial pressure, and lower systemic vascular resistance index with a similarly elevated mean cardiac index. Despite norepinephrine administration at a mean peak dose of 7.3±6.4 µg/min the mean post-operative change in creatinine was not different between two groups on days 0, 2 or 4 after surgery.

Conclusions

Norepinephrine does not increase post-operative serum creatinine concentrations in patients with hypotensive vasodilatation after cardiac surgery. Concerns related to its potential adverse effects on the kidney function in this setting appear unjustified.

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Title: Norepinephrine for hypotensive vasodilatation after cardiac surgery: impact on renal function
Authors: Hiroshi Morimatsu
Shigehiko Uchino
John Chung
Rinaldo Bellomo
Jai Raman
Brian Buxton
Publication date: 01-07-2003
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 7/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-003-1810-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Norepinephrine for hypotensive vasodilatation after cardiac surgery: impact on renal function

Abstract

Objectives

Design and setting

Patients

Intervention

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Design and setting

Patients

Intervention

Measurements and results

Conclusions

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