The Effects of Massive Administration of Corticosteroid on Renal Function During and After Open Heart Surgery. Clinical and Experimental studies.
1973 Volume 25 Issue 2 Pages 195-214
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1973 Volume 25 Issue 2 Pages 195-214
The effects of the massive administration of corticosteroid on renal function during and after the extracorporeal circulation had been studied clinically on sixty patients undergoing open heart surgery who consisted of forty-five patients given dexamethasone 30 to 60 minutes before the extracorporeal circulation and fifteen patients without pdethxeaarmsa aye thcoasnotrnoel, and experimentally on ten mongrel dogs unde rgoing total body perfusion, and the following results had been obtained.
1) Dexamethasone, given in massive doses, enhanced th e renal function during and after the extracorpoeal circulation. Clinically and experimentally, the urinary output increased and experimentally, glomerular filtration rate and renal blood flow were satisfactorily maintained during and after perfusion by a large administration of dexamethasone.
2) One mg/Kg of dexamethasone may be an adequate dose, but the effect of dexamethasone on renal function by the administrated dosage may differ between children and adults, and its effect was more remarkably in children than in adults.
3) The increased urinary output continued until 24 hours after the extracorporeal circulation and a mutual correlation was demonstrated between the urinary volume and the excretion of urinary potassium in the patients given more than 1 mg/Kg of dexamethasone. The increased urinary volume was not due to water diuresis, but was due to solute diuresis associated with a rise of excreted potassium in urine. Judgi ng from these results, dexamethasone might act on the distal renal tubules.
4) No significant relationship between the plasma antidiuretic hormone level and the urinary output during and after perfusion was seen, and the antidiuretic hormone value during perfusion increased and it immediately after perfusion decreased irrespective of dexamethasone administration. Therefore, dexamethasone may have no effect on the plasma antidiuretic hormone.
