Plasma renin activity and urine beta 2-microglobulin during and after cardiopulmonary bypass: pulsatile vs non-pulsatile perfusion

in European Heart Journal (1990), 11(12), 1079-1082

Fourteen patients with normal preoperative renal function underwent aortocoronary bypass graft using cardiopulmonary bypass (CPB) with pulsatile (P;n = 7) or non pulsatile (NP;n = 7) perfusion. In the two ... [more ▼]

Fourteen patients with normal preoperative renal function underwent aortocoronary bypass graft using cardiopulmonary bypass (CPB) with pulsatile (P;n = 7) or non pulsatile (NP;n = 7) perfusion. In the two groups prebypass values of plasma renin activity (PRA) and urine beta 2-microglobulin (beta 2-M) were within normal limits. PRA increased significantly during CPB and the first 6 h after CPB only in the non-pulsatile group. In both groups, the urine beta 2-M level increased significantly during and after CPB; however, there was no significant difference in urine beta 2-M levels between the two groups. Also, the amount of beta 2-M excreted in urines per unit of time increased significantly in both groups during and after CPB; there was no significant difference between the two groups. [less ▲]

Fluid management and plasma renin activity in organ donors

in Transplant International : Official Journal of the European Society for Organ Transplantation (1989), 2(3), 129-132

Fluid management and assessment of organ perfusion in organ donors with hypotonic polyuria remain poorly investigated problems. In our protocol, urinary losses (565 +/- 202 ml/h) were replaced volume for ... [more ▼]

Fluid management and assessment of organ perfusion in organ donors with hypotonic polyuria remain poorly investigated problems. In our protocol, urinary losses (565 +/- 202 ml/h) were replaced volume for volume by 3.3% dextrose/0.3% natrium chloride solution (Baxter) with 20 mmol/l potassium chloride. Concentrated red blood cells were administered to maintain hematocrit at about 30%, and volume expansion (central venous pressure above 6 mmHg) was obtained by gelatin (haemaccel) infusion. In all donors (n = 9), plasma electrolytes remained within normal limits despite hypotonic polyuria. Suppression of initial plasma renin activity (PRA: 9.7 +/- 3.6 ng/ml per hour) was obtained by subacute volume expansion. In eight donors the hemodynamic status improved, dopamine administration, when used, was discontinued, and PRA decreased (2.3 +/- 0.7 ng/ml per hour; P less than 0.05). The only donor who failed to respond to fluid therapy had increased PRA (24.2 ng/ml per hour). During fluid challenge, an inverse relationship was demonstrated between mean arterial pressure and PRA in all nine donors (r = -0.61; P less than 0.001), while there were no significant changes in blood urea. creatinine, or urine output. It is concluded that in organ donors, proper maintenance of the hemodynamic status and suppression of the renin stress response may be obtained by an adequate fluid management, involving both qualitative restoration and expansion of intravascular volume. [less ▲]

Interest of Face Mask--Cpap in One Case of Severe Accidental Hypothermia

in Acta Anaesthesiologica Belgica (1989), 40(4), 281-3

one case of severe accidental hypothermia; rectal temperature was 25 degrees C. Hypoxemia unmodified by 100 O2 inhalation in an ordinary face-mask was easily corrected using a face-mask CPAP; a ... [more ▼]

one case of severe accidental hypothermia; rectal temperature was 25 degrees C. Hypoxemia unmodified by 100 O2 inhalation in an ordinary face-mask was easily corrected using a face-mask CPAP; a ventilation-perfusion mismatching could be implicated in the cold induced hypoxemia. Active rewarming (1.5 degrees C/h) was pursued from 25 to 37 degrees C, using non aggressive methods: warming blankets and a Bennett heated humidifier inserted in the CPAP system. Even in severe hypothermia successful results may be obtained without resort to sophisticated methods. [less ▲]

Le prélèvement multiorganes: maillon essentiel d'une chaîne de solidarité

in Revue Médicale de Liège (1989), XLIII(4), 138-148

Un cas de maladie métabolique hépatique de Wilson traité radicalement par une transplantation de foie

in Revue Médicale de Liège (1988), 43

Les auteurs présentent un cas de cirrhose, développée sur une maladie de Wilson. Une greffe orthotopique de foie a été réalisée avec succès. Ils reprennent les principales indications de cette technique ... [more ▼]

Les auteurs présentent un cas de cirrhose, développée sur une maladie de Wilson. Une greffe orthotopique de foie a été réalisée avec succès. Ils reprennent les principales indications de cette technique et décrivent également les manifestations de la maladie de Wilson en général et son diagnostic. [less ▲]