상복강 대동맥 교차차단 및 재관류 시 Fenoldopam 투여가 허혈성 신 손상에 미치는 영향

Abstract

Background: The overall rate of renal complication after surgery on the suprarenal aorta remains high. In this study, the changes in renal blood flow (RBF), urinary oxygen tension (PuO2), renal vascular resistance (RVR), and urinary volume following fenoldopam administration were investigated in supraceliac aortic cross-clamping and unclamping animal model. Methods: Twelve dogs were divided into two groups; control group (n = 6), fenodopam group (n = 6). After brachial, femoral, and pulmonary arterial catheterization, midline abdominal incision was made. For the aortic cross-clamping the supraceliac aorta was exposed. A doppler flowmeter probe was placed around right renal artery. A ureteral catheter was positioned at the right renal pelvis to measure urine volume and urinary oxygen tension (PuO2). In fenoldopam group, 0.5μg/kg/min of fenoldopam was administered immediately before suprarenal aortic reperfusion. Systemic hemodynamics, renal blood flow, renal vascular resistance, PuO2, and urine volume were compared between two groups. Results: The systemic hemodynamics were not significantly different between the two groups throughout the experiment. After aortic reperfusion, the RVR significantly increased in control group, but the RVR in fenoldopam group remained to baseline level. The urine output, RBF, and PuO2 significantly increased in fenoldopam group compared to control group. BUN and serum creatinine were not different between the two groups. Conclusions: High dose of fenoldopam administration reverse ischemic renal insufficiency after supraceliac aortic cross clamping. (Korean J Anesthesiol 2007; 52: 202∼11)