Document Detail


Dexmedetomidine infusion is associated with enhanced renal function after thoracic surgery.
MedLine Citation:
PMID:  16980158     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To test the hypothesis that dexmedetomidine, a selective alpha-2 agonist, enhances urine flow rate and perioperative renal function, a post hoc analysis was conducted on a recently completed study of dexmedetomidine used as an adjunct to epidural analgesia after thoracotomy.
DESIGN: Post hoc analysis of a randomized, placebo-controlled, double-blind clinical trial.
SETTING: Tertiary-care university medical center.
PATIENTS: 28 patients undergoing elective thoracotomy.
INTERVENTIONS: Patients were prospectively randomized to receive a supplemental 24-hour intravenous infusion of either dexmedetomidine (0.4 microg kg(-1) h(-1), n = 14) or saline placebo (equivalent infusion rate, n = 14).
MEASUREMENTS: Available renal parameters including urine output, calculated creatinine clearance (cCl(Cr)), daily serum creatinine level (S(Cr)), and the fractional change in S(Cr) level (DeltaS(Cr)%, [peak postoperative S(Cr) - baseline S(Cr)] / baseline S(Cr)) x 100) were recorded.
MAIN RESULTS: Values are expressed as means +/- SD. There were no significant differences in baseline values between the groups. The dexmedetomidine group had significantly greater cumulative urine output at postoperative hour 4 (473 +/- 35 vs 290 +/- 122 mL, P = 0.001) and 12 (1033 +/- 240 vs 822 +/- 234 mL, P = 0.02), although only 14% of the group received diuretic agents, compared with 43% in the control group. The dexmedetomidine group had significantly better preserved perioperative renal function compared with the control group, as assessed by DeltaS(Cr)% (0.04% decrease vs 21% increase, P = 0.0007) and cCl(Cr) (75.3 +/- 13.2 vs 62.5 +/- 15.5 mL/min, P = 0.02).
CONCLUSION: Dexmedetomidine infusion administered as a supplement to epidural analgesia induced diuresis in postthoracotomy patients with normal preoperative renal function and undergoing fluid restriction. Although this finding may represent simple reversal of a tubular antidiuresis, the lower DeltaS(Cr)% and preservation of cCl(Cr) suggest a beneficial effect on glomerular filtration compared with controls.
Authors:
Robert J Frumento; Helene G Logginidou; Staffan Wahlander; Gebhard Wagener; Hugh R Playford; Robert N Sladen
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Retracted Publication    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  18     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-18     Completed Date:  2006-10-26     Revised Date:  2013-11-13    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  422-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, NY 10032-3784, USA.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic alpha-Agonists / pharmacology*
Adult
Aged
Analgesia, Epidural*
Dexmedetomidine / administration & dosage,  pharmacology*
Double-Blind Method
Female
Glomerular Filtration Rate / drug effects
Humans
Kidney / drug effects*,  physiology
Kidney Function Tests
Male
Middle Aged
Prospective Studies
Thoracotomy*
Chemical
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 113775-47-6/Dexmedetomidine
Comments/Corrections
Retraction In:
J Clin Anesth. 2013 Aug;25(5):432

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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