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Intrarenal pressures remain low with placement of a dual lumen catheter for retrograde irrigation to induce renal hypothermia.
MedLine Citation:
PMID:  22581425     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether placement of a 10 French dual lumen catheter produces a low-pressure collecting system during retrograde irrigation to induce renal hypothermia. Indication for the study is as a potential adjunct for partial nephrectomy. METHODS: Ex vivo porcine kidneys underwent harvest, and a ureteral catheter (either single lumen or dual lumen) was placed in the ureter within the renal pelvis. Pressure measurements (n = 1,080) were recorded at 1-s intervals. Irrigant flow rates were initiated at gravity and subsequently increased at 10 cc/min increments to a maximum of 100 cc/min. RESULTS: During retrograde infusion without a dual lumen catheter, every 10 cc/min rate increase resulted in an 8 cm H(2)O rise in intrarenal pressure. The maximum flow rate obtained was 20 cc/min before urinary extravasation or intrarenal drainage occurred. Maximum pressure obtained before urinary extravasation or collecting system perforation was 16 cm H(2)O. Placement of a dual lumen catheter within the renal pelvis allowed intrarenal pressures to remain less than 5 cm H(2)O (when infusion rates <80 cc/min). The maximum flow rate while maintaining pressures <20 cm H(2)O was 90 cc/min. Flow rates above 100 cc/min resulted in urinary extravasation. The maximal flow rate that is safe for collecting systems with a dual lumen catheter is 80 cc/min, and without a dual lumen catheter rates greater than 20 cc/min resulted in collecting system perforations. CONCLUSION: Using an ex vivo porcine model, application of a 10 French ureteral dual lumen catheter produced adequate retrograde drainage that resulted in low intrarenal pressures at high infusion rates (up to 80 cc/min).
Authors:
J Colli; K Cotter; P Dorsey; G Mitchell; B R Lee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-12
Journal Detail:
Title:  International urology and nephrology     Volume:  -     ISSN:  1573-2584     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0262521     Medline TA:  Int Urol Nephrol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Urology, Tulane University School of Medicine, 1430 Tulane Avenue, SL-42, Room 3522, New Orleans, LA, 70112, USA, jcolli.tulane@gmail.com.
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