[The perioperative management of dialysis for patients undergoing coronary artery bypass surgery with chronic renal failure].
Several methods of dialysis have been employed to maintain the perioperative water-electrolyte balance caused by the disorders with chronic renal failure. We have experienced 13 cases of coronary artery bypass surgery with chronic renal failure, and employed hemodialysis (HD) in 5 cases, hemodialysis with extracorporeal ultrafiltration method (HD + ECUM) in 5 cases, continuous ambulatory peritoneal dialysis (CAPD) in 3 cases for perioperative management. The perioperative changes of the circulatory blood volume and the fluid-balance, were assumed by positive reaction with varied over 60 mmHg in systolic blood pressure or demanded over double dose of catecholamines in each observed terms until the next day of the patients extubated. The cases with HD or HD + ECUM have changed the blood pressure more frequently (HD cases = 21%, HD + ECUM cases = 19%) than the cases with CAPD (CAPD cases = 3%). We conclude that the each methods are available to manage perioperative dialysis to undergo coronary artery bypass grafting should be employed with some techniques, CAPD will be the most favorable method to maintain the fluid balance stably for patients with severe compromised cardiac function.
Department of Cardiovascular Surgery, Mitsui Memorial Hospital.
T
T
Saito
Y
Y
Terada
S
S
Fukuda
T
T
Takayama
H
H
Suma
Y
Y
Wanibuchi
S
S
Furuta
K
K
Iwahashi
D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications* / Q000601:surgery; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008875:Middle Aged; D006435:Renal Dialysis / Q000379:methods*