Fluid Management and Renal Function During a Laparoscopic Case Done Under CO2 Pneumoperitoneum

2006 ◽  
pp. 281-287
Author(s):  
Gamal Mostafa ◽  
Frederick L. Greene
Keyword(s):  
Renal Function ◽  
Fluid Management ◽  
Co2 Pneumoperitoneum ◽  
Laparoscopic Case

scholarly journals Intraoperative Fluid Excess Is a Risk Factor for Pancreatic Fistula after Partial Pancreaticoduodenectomy

HPB Surgery ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Helge Bruns ◽  
Veronika Kortendieck ◽  
Hans-Rudolf Raab ◽  
Dalibor Antolovic
Keyword(s):  
Renal Function ◽  
Risk Factor ◽  
Filtration Rate ◽  
Roc Analysis ◽  
Fluid Management ◽  
The Other ◽  
Laboratory Findings ◽  
Pancreatic Fistulas ◽  
Partial Pancreaticoduodenectomy ◽  
First Time

Background. After pancreaticoduodenectomy (PD), pancreatic fistulas (PF) are a frequent complication. Infusions may compromise anastomotic integrity. This retrospective analysis evaluated associations between intraoperative fluid excess and PF. Methods. Data on perioperative parameters including age, sex, laboratory findings, histology, infusions, surgery time, and occurrence of grade B/C PF was collected from all PD with pancreaticojejunostomy (PJ) performed in our department from 12/2011 till 02/2015. The glomerular filtration rate (GFR), infusion rate, and the ratio of both and its association with PF were calculated. ROC analysis was employed to identify a threshold. Results. Complete datasets were available for 83 of 86 consecutive cases. Median age was 66 years (34–84; 60% male), GFR was 93 mL/min (IQR 78–113), and surgery time was 259 min (IQR 217–307). Intraoperatively, 13.6 mL/min (7–31) was infused. In total, n=18 (21%) PF occurred. When the infusion : GFR ratio exceeded 0.15, PF increased from 11% to 34% (p=0.0157). No significant association was detected for any of the other parameters. Conclusions. This analysis demonstrates for the first time an association between intraoperative fluid excess and PF after PD with PJ even in patients with normal renal function. A carefully patient-adopted fluid management with due regard to renal function may help to prevent postoperative PF.

Effects of Enalaprilat on the Renin-Angiotensin-Aldosterone System and on Renal Function during CO2 Pneumoperitoneum

2005 ◽  
Vol 19 (8) ◽  
pp. 1026-1031 ◽  
Author(s):  
Marcelo Rodrigues Borba ◽  
Roberto Iglesias Lopes ◽  
Murilo Carmona ◽  
Boulangier Mioto Neto ◽  
Sérgio Carlos Nahas ◽  
...  
Keyword(s):  
Renal Function ◽  
Co2 Pneumoperitoneum ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin

scholarly journals The role of pneumoperitoneum in the glomerular filtration in an experimental model with 2/3 reduction of the renal mass

2017 ◽  
Vol 39 (1) ◽  
pp. 89
Author(s):  
Marco Aurélio Valadão ◽  
Djalma José Fagundes ◽  
Willian Cesar Cavazana ◽  
Gabriel Jorge Fagundes
Keyword(s):  
Renal Function ◽  
Glomerular Filtration ◽  
Renal Mass ◽  
Inulin Clearance ◽  
Male Rats ◽  
Urinary Volume ◽  
Co2 Pneumoperitoneum ◽  
Wistar Male Rats ◽  
Better Than

Objective: To evaluate the influence of the CO2 pneumoperitoneum in the glomerular filtration in a rat model with a 2/3 reduction of renal parenchyma. Methods: Adult Wistar male rats (n = 50) were subjected to right nephrectomy and a 2/3 ligature of the renal left vascular branch. Animals were randomly distributed as follows: GI (n = 10) - simulated, GII (n = 20) –8 mm Hg pneumoperitoneum, and GIII (n = 20) –15 mm Hg pneumoperitoneum. After two (GIIA and GIIIA) and three (GIIB and GIIIB) hours of insufflation, and one hour of disinsufflation, they were evaluated for the following aspects: mean blood pressure (MBP), microhematocrit, urinary volume and inulin clearance. Results: The microscopic aspects showed signs of glomerulosclerosis that caused proteinuria. Renal function with8 mm Hg pneumoperitoneum after two hours of disinsufflation (Δ% = 202.68) was better than after three hours (Δ% = 10.89). With15 mm Hg pneumoperitoneum, the renal function was damaged by both procedures, that is, two (Δ% = -3.57) and three hours (Δ% = -3.25). Conclusion: Inulin clearance evidenced renal insufficiency in the model with a 2/3 reduction of renal mass, and depending on both the increase of the exposure time and the pressure intensity, it can be more intensified. 

scholarly journals Effect of Intravascular Volume Expansion on Renal Function During Prolonged CO2 Pneumoperitoneum

2000 ◽  
Vol 231 (2) ◽  
pp. 195-201 ◽  
Author(s):  
Eric T. London ◽  
Hung S. Ho ◽  
Ann M. C. Neuhaus ◽  
Bruce M. Wolfe ◽  
Steven M. Rudich ◽  
...  
Keyword(s):  
Renal Function ◽  
Volume Expansion ◽  
Intravascular Volume ◽  
Co2 Pneumoperitoneum

scholarly journals Associations Between Restrictive Fluid Management and Renal Function and Tissue Perfusion in Adults With Severe Falciparum Malaria: A Prospective Observational Study

2019 ◽  
Vol 221 (2) ◽  
pp. 285-292
Author(s):  
Haruhiko Ishioka ◽  
Katherine Plewes ◽  
Rajyabardhan Pattnaik ◽  
Hugh W F Kingston ◽  
Stije J Leopold ◽  
...  
Keyword(s):  
Renal Function ◽  
Observational Study ◽  
Falciparum Malaria ◽  
Prospective Observational Study ◽  
Fluid Intake ◽  
Fluid Management ◽  
Tissue Perfusion ◽  
Total Fluid Intake ◽  
Severe Falciparum Malaria ◽  
Total Fluid

Abstract Background Liberal fluid resuscitation has proved harmful in adults with severe malaria, but the level of restriction has not been defined. Methods In a prospective observational study in adults with severe falciparum malaria, restrictive fluid management was provided at the discretion of the treating physician. The relationships between the volume of fluid and changes in renal function or tissue perfusion were evaluated. Results A total of 154 patients were studied, 41 (26.6%) of whom died. Median total fluid intake during the first 6 and 24 hours from enrollment was 3.3 (interquartile range [IQR], 1.8–5.1) mL/kg per hour and 2.2 (IQR, 1.6–3.2) mL/kg per hour, respectively. Total fluid intake at 6 hours was not correlated with changes in plasma creatinine at 24 hours (n = 116; rs = 0.16; P = .089) or lactate at 6 hours (n = 94; rs = −0.05; P = .660). Development of hypotensive shock or pulmonary edema within 24 hours after enrollment were not related to the volume of fluid administration. Conclusions Restrictive fluid management did not worsen kidney function and tissue perfusion in adult patients with severe falciparum malaria. We suggest crystalloid administration of 2–3 mL/kg per hour during the first 24 hours without bolus therapy, unless the patient is hypotensive.

scholarly journals IVC Measurements in Critically Ill Patients with Acute Renal Failure

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Rami Jambeih ◽  
Jean I. Keddissi ◽  
Houssein A. Youness
Keyword(s):  
Renal Function ◽  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Fluid Management ◽  
Vena Cava ◽  
Kidney Injury ◽  
Bedside Ultrasound ◽  
Group 2 ◽  
Group 1

Objective. To determine whether the inferior vena cava (IVC) measurement by bedside ultrasound (US-IVC) predicts improvement in renal function in patients with acute kidney injury (AKI). Design. Prospective observational study. Setting. Medical intensive care unit. Patients. 33 patients with AKI were included. Intervention. US-IVC was done on admission. The patients’ management was done by the primary teams, who were unaware of the US-IVC findings. Two groups of patients were identified. Group 1 included patients who were managed in concordance with their US-IVC (potential volume responders who had a positive fluid balance at 48 h after admission and potential volume nonresponders who had an even or negative fluid balance at 48 hours after admission). Group 2 included patients in whom the fluid management was discordant with their US-IVC. Measurements and Main Results. At 48 hours, Group 1 patients had a greater improvement in creatinine [85% versus 31%, p=0.0002], creatinine clearance (78±93% versus 8±64%, p=0.002), and urine output (0.86±0.54 versus 0.45±0.36 ml/Kg/h, p=0.03). Conclusion. In critically ill patients with AKI, concurrence of fluid therapy with IVC predicted fluid management, as assessed by bedside ultrasound, was associated with improved renal function at 48 hours. This trial is registered with ClinicalTrials.gov registration number: NCT02064244.

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