[Anuria after abdominal surgery in 2 newborn infants. Beneficial effect of noradrenaline].
BACKGROUND
Abdominal surgery in neonates may be complicated by acute renal failure that is sometimes due to increased intra-abdominal pressure. Correction of the decreased renal perfusion may be difficult.


METHODS
Case no 1. A girl weighing 3,000 g was operated on at 3 hours of life for congenital omphalocele. Closing the defect induced increased intra-abdominal pressure and decreased systemic pressure. Despite dopamine, dobutamine, followed by furosemide, anuria persisted without manifestations of heart failure. Noradrenaline (0.1 to 0.7 micrograms/kg/min intravenously) given 24 hours after surgery resulted in normalization of systemic pressure and diuresis. Case no 2. A boy was born at gestational week 30, weighing 1,450 g. At 8 days of age, he was suffering from shock that was attributed to perforation of the bowel due to necrotizing enterocolitis. Surgery was complicated by acute circulatory and renal failure that did not respond to dopamine, dobutamine or furosemide. Infusion of noradrenaline, (0.2 to 0.6 micrograms/kg/min intravenously) induced diuresis within 3 hours.


CONCLUSIONS
Noradrenaline can be useful in patients with postoperative increased intra-abdominal pressure. It should only be given after correction of hypovolemia, control of myocardial function, and when dopamine remains ineffective.
Casadevall
I
I
Service de Réanimation Pédiatrique Polyvalente, Hôpital Robert-Debré, Université Paris VII.
Kazandjian
V
V
Germain
J F
JF
Daoud
P
P
Maherzi
S
S
Desplanques
L
L
Beaufils
F
F
D000005:Abdomen / Q000503:physiopathology / Q000601:surgery*; D001002:Anuria / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009638:Norepinephrine / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy* / Q000503:physiopathology; D011312:Pressure
D009638:Norepinephrine
Anurie après chirurgie abdominale chez deux nouveau-nés. Effet bénéfique de la noradrénaline.