Independence of Renin Production and Hypertension in Abdominal Aortic Aneurysmectomy

Grindlinger, Gene A.; Vegas, A. M.; Williams, Gordon H.; Mannick, John A.; Hechtman, Herbert B.

doi:10.1097/00132586-198202000-00010

Cited by 6 publications

(7 citation statements)

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“…A angiotensina II, além de potente vasoconstritor com ação direta na musculatura lisa dos vasos, atua na supra-renal, aumentando a produção de aldosterona, cuja ação principal é aumentar a reabsorção de sódio e água no segmento cortical coletor. A maioria dos autores tem observado aumento de atividade do sistema renina-angiotensina durante o pinçamento aórti-co, no cão 38 e no homem [39][40][41] . O aumento da atividade da renina pode ser facilmente explicado no pinçamento torácico ou supra-renal da aorta, quando ocorre diminuição da pressão de perfusão das arteríolas aferentes renais.…”

Section: Discussionunclassified

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Efeitos do halotano, isoflurano e sevoflurano sobre a função renal em cães sob pinçamento aórtico infra-renal

Bisinotto¹,

Bráz²

2003

Rev. Bras. Anestesiol.

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Section: Discussionunclassified

“…Most authors have observed increased renin-angiotensin-aldosterone system activity during aortic cross-clamping in dogs 38 and humans [39][40][41] . Renin activity increase may be easily explained during supra-renal aortic cross-clamping when there is decreased perfusion pressure of renal afferent arterioles.…”

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confidence: 99%

Efeitos do halotano, isoflurano e sevoflurano sobre a função renal em cães sob pinçamento aórtico infra-renal

Bisinotto¹,

Bráz²

2003

Rev. Bras. Anestesiol.

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“…) with the aim of inhibiting plasma ACE activity, and hence angiotensin II synthesis, for at least 24 h. Indeed, elevated PRA has been reported after surgical incision and increased angiotensin II plasma concentrations are known to culminate at the time of unclamping and to persist for more than 6 h after operation [9,10,14]. We also found that lower enalapril doses (10 and 30 g kg…”

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confidence: 61%

Preoperative inhibition of angiotensin-converting enzyme improves systemic and renal haemodynamic changes during aortic abdominal surgery

Licker

Bednarkiewicz

Neidhart

et al. 1996

British Journal of Anaesthesia

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SummaryWe studied 22 patients undergoing aortic surgery, allocated randomly to receive, before induction of anaesthesia, a single i.v. dose of enalapril 50 g kg 91 or saline. During infrarenal aortic crossclamping, we observed similar reductions in oxygen uptake in the two groups, despite greater systemic oxygen delivery in enalapril-treated patients; angiotensin-converting enzyme inhibition prevented the reduction in cardiac output and attenuated the decrease in glomerular filtration. Changes in glomerular filtration secondary to aortic clamping were related positively to changes in renal plasma flow (r : 0.83 (saline group) and r : 0.65 (enalapril group)). Creatinine clearance on the first day after operation was significantly higher in the enalapril compared with the saline group. We conclude that enalapril pretreatment is effective in improving systemic oxygen delivery, renal plasma flow and glomerular filtration during aortic abdominal surgery. (Br.

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“…tration during procedures of aortic cross-clamping and unclamping, which can be easily explained by the decrease in perfusion in afferents arterioles during ischemia [23][24][25] . The major effects of angiotensin II are increase in vascular renal resistance and tubular sodium absorption, acting directly on the tube and indirectly through the increase in aldosterone production 26 .…”

Section: Discussionmentioning

confidence: 99%

Metabolic and hemodynamic effects of saline infusion to maintain volemia on temporary abdominal aortic occlusion

Amorim¹,

Pinheiro²,

Romaldini³

2002

Arq. Bras. Cardiol.

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Objective -To analyze hemodynamic and metabolic effects of saline solution infusion in the maintenance of blood volume in ischemia-reperfusion syndrome during temporary abdominal aortic occlusion in dogs.Methods -We studied 20 dogs divided into 2 groups: the ischemia-reperfusion group (IRG, n=10) and the ischemia-reperfusion group with saline solution infusion aiming at maintaining mean pulmonary arterial wedge pressure between 10 and 20 mmHg n=10 . Severe hypotension, associated with a decrease in cardiac output is a well-known event occurring after declamping, and hypovolemia is considered the main cause of this event [3][4][5][6][7][8] . Maintenance of renal function, prevention of hepatic and splanic circulatory failure and preservation of gastroinstestinal tract intensity are important consequences of hemodynamic stability [8][9][10][11] . Fluid administration followed by adequate monitoring based on the physiology of cardiac function, according to the Frank-Starling mechanism, promotes good myocardial performance during surgical stress and in the postoperative period. It improves cardiac output and maintains systemic blood pressure, which is important for maintaining adequate coronary blood flow, thereby protecting the heart, especially in patients with significant coronary occlusive disease 11 . Several authors [4][5][6]12,13 showed that maintenance of pulmonary artery wedge pressure between 10 and 18 mmHg during this procedure could prevent a decline in cardiac output and hypotension after aortic declamping.However, management of fluid infusion is difficult in these patients due to the complexity of factors involved, such as preoperative cardiac function and multiple risk factors present in the intraoperative period, such as administering anesthetic drugs and mechanical positive pressure ventilation. This is important especially in these patients that usually have heart disease, where inappropriate volume loading is dangerous 5 . Acknowledging the importance of the study of ischemia-reperfusion lesion and knowing the capacity of it in determining systemic alterations, even in distant organs, we studied the effects of saline solution infusion to maintain mean pulmonary artery wedge pressure between 10 and 20 mmHg during aortic ischemia-reperfusion in an experimental model in dogs, especially in the shock phase after aortic declamping, over hemodynamic and metabolic alterations. MethodsTwenty adult, male, mongrel dogs, weighing between 12 and 23 kg were intravenously anesthetized with sodium

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Independence of Renin Production and Hypertension in Abdominal Aortic Aneurysmectomy

Cited by 6 publications

References 0 publications

Efeitos do halotano, isoflurano e sevoflurano sobre a função renal em cães sob pinçamento aórtico infra-renal

Efeitos do halotano, isoflurano e sevoflurano sobre a função renal em cães sob pinçamento aórtico infra-renal

Preoperative inhibition of angiotensin-converting enzyme improves systemic and renal haemodynamic changes during aortic abdominal surgery

Metabolic and hemodynamic effects of saline infusion to maintain volemia on temporary abdominal aortic occlusion

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