Original ArticlesMannitol, furosemide, and dopamine infusion in postoperative renal failure complicating cardiac surgery
Section snippets
Material and methods
At Newark Beth Israel Medical Center, during a period of four years, ie, from October 1994, to September 1998, an average of 730 operations per year were performed in adults for acquired cardiac disease. During this period, patients who manifested either acute oliguric or anuric renal failure in the postoperative period, with adequate postoperative cardiac output and tissue perfusion were prospectively evaluated and, in 100 patients, such acute renal dysfunction was recognized in the
Results
Preoperative patient characteristics, associated comorbid features, did not assume statistical significance between groups A and B, and patients had mean age of 71 years with moderately depressed left ventricular ejection fraction (EF 0.35). In patients with preoperative normal renal function (n = 56), the preoperative mean serum creatinine was 0.9 ± 0.03. In patients with preexisting renal disease (n = 44), the preoperative mean serum creatinine was 2.7 ± 0.03. After the onset of acute renal
Comment
The definition of acute postoperative renal failure varied from study to study. Although some define renal failure as a decrease in renal function that results in need for dialysis or a serum creatinine level of 2.5 mg% or more, in the present study and studies of others, it was defined as: (1) an increase in serum creatinine level of 0.5 mg/dL or more; (2) an increase of more than 50% over the baseline creatinine value; or (3) 50% or more decrease in calculated creatinine clearance 6, 7, 8, 9,
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