title: Effects of ephedrine on renal function in patients after major vascular surgery.
abstract: The haemodynamic and renal effects of ephedrine were studied in 11 mechanically ventilated patients on the first day after major vascular surgery. Ephedrine, a sympathomimetic agent with alpha-1, beta-1, and beta-2 agonistic activity, was infused into 11 patients to achieve a 20% rise in systolic blood pressure. The doses used were 2-6 micrograms/kg/min, and in six of these 11 patients the dose was then doubled, 4-12 micrograms/kg/min for another renal function test. Blood pressure, heart rate, and cardiac output increased at both dose-ranges. Systolic pulmonary arterial pressure increased by 10% at the first dose-range. Systemic vascular resistance was unchanged and plasma catecholamine levels were unaltered in the present study. Plasma renin activity diminished by 18% and 6%, respectively. Clearance of para-aminohippuric acid increased by 20% and 6%, at the two dose-ranges, while clearance of inulin and urine flow rate increased by 24% and 29%, respectively, at the first dose-range, without further increase during the second dose-range. Fractional chloride excretion, and fractional osmolar clearance were unaltered. Fractional Na+ clearance rose by 30% and 36%, respectively. Fractional free water clearance diminished by 8% at the second dose-range. When comparing the two dose-ranges, HR, systolic and mean BP rose by 8%, 13% and 11%, respectively. Fractional K+ excretion diminished by 30%. We conclude that ephedrine given as a continuous infusion seems to have beneficial effects on renal function in patients after elective major vascular surgery.
authors.affiliation: Department of Anaesthesiology, Karolinska Hospital, Stockholm, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Westman
authors.forename: B
authors.initials: B
authors.lastname: Hamberger
authors.forename: P O
authors.initials: PO
authors.lastname: Järnberg
mesh_terms: D000368:Aged; D004809:Ephedrine / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007668:Kidney / Q000187:drug effects* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012079:Renal Circulation / Q000187:drug effects; D013268:Stimulation, Chemical; D014656:Vascular Surgical Procedures
chemical_list: D004809:Ephedrine