Maximal Hydration During Anesthesia Increases Pulmonary Arterial Pressures and Improves Early Function of Human Renal Transplants

Carlier, Marianne; Squifflet, Jean‐Paul; Pirson, Yves; Gribomont, Bernard; Alexandre, Guy P.

doi:10.1016/s0022-5347(17)51042-3

Cited by 28 publications

(42 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Further prospective studies are needed to assess the potential impact of the laparoscopic procurement mode on early graft function. Corroboration of our observations by these studies would provide added rationale for strict adherence to management principles that have been shown to be renoprotective in previous studies, including aggressive intravascular volume expansion (15) and the use of agents that potentially enhance renal perfusion (30,32) during donor nephrectomy, as well as the targeting of specific intraoperative hemodynamic goals during kidney implantation in the recipient (33). Also, if laparoscopic nephrectomy were definitively shown to exert an adverse impact on early graft function, additional studies with longer followup times would need to investigate the potential long-term consequences of this new procurement mode with regard to rejection and long-term graft survival.…”

Section: Discussionsupporting

confidence: 52%

Laparoscopic (vs. Open) Live Donor Nephrectomy: A UNOS Database Analysis of Early Graft Function and Survival

Troppmann

Ormond²,

Perez

2003

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 52%

Laparoscopic (vs. Open) Live Donor Nephrectomy: A UNOS Database Analysis of Early Graft Function and Survival

Troppmann

Ormond²,

Perez

2003

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…Renal transplantation is the typical clinical situation in which considerable amounts of intravenous fluids are administered normally to patients with end-stage renal disease. Indeed, despite some controversies [47], patients undergoing renal transplantation still receive, in many centres, large amounts of intravenous fluids (up to 30 mL kg -1 h -1 ), in the attempt to increase their intravascular volume and therefore improve graft function [48]. A survey recently performed in the United States pointed out that 0.9% NaCl, and 0.9% NaCl-based intravenous solutions, were the most commonly employed intravenous solutions during renal transplantation.…”

Section: Renal Transplantation and Intravenous Fluidsmentioning

confidence: 99%

Intravenous balanced solutions: from physiology to clinical evidence

Länger

Santini

Scotti

et al. 2015

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

Abstract"Balanced" solutions are commonly defined as intravenous fluids having an electrolyte composition close to that of plasma. As such, they should minimally affect acid-base equilibrium, as compared to the commonly reported 0.9% NaCl-related hyperchloremic metabolic acidosis. Recently, the term "balanced" solution has been also employed to indicate intravenous fluids with low chloride content, being the concentration of this electrolyte the most altered in 0.9% NaCl as compared to plasma, and based upon a suggested detrimental alteration of renal function associated with hyperchloremia. Despite efforts made towards its identification, the ideal balanced solution, with minimal effects on acid-base status, low chloride content, and adequate tonicity, is not yet available. After the accumulation of pre-clinical and clinical physiologic data, in the last three years, several clinical trials, mostly observational and retrospective, have addressed the question of whether the use of balanced solutions has beneficial effects as compared to the standard of care, sometimes even suggesting an improvement in survival. Nonetheless, the first large randomized controlled trial comparing the effects of a balanced vs. unbalanced solutions on renal function in critically-ill patients (SPLIT trial, the 0.9% saline vs. Plasma-Lyte 148 for Intensive Care Unit Fluid Therapy), just recently published, showed identical equipoise between the two treatments. In the present review, we offer a comprehensive and updated summary on this issue, firstly, by providing a full physiological background of balanced solutions; secondly, by summarizing their potential pathophysiologic effects; and lastly, by presenting the clinical evidence available to support their use at the present time.

show abstract

“…Fluid redistribution in different compartments as a result of preexisting vascular permeability may also be responsible for the decrease in CVP. Graft acute tubular necrosis has been reported to be lower in patients who are vigorously hydrated [43][44][45]. Ferris et al found no correlation between the decrease in CVP and fluid balance although the fluid balance of recipients correlated strongly with immediate post-operative graft function [46].…”

Section: Anesthetic Managementmentioning

confidence: 99%