[Blood purification after aorto-coronary bypass grafting for dialysis patients].
Four dialysis patients received aorto-coronary bypass grafting (CABG) at Fukuyama cardiovascular hospital from April 1989 to March 1992. We employed continuous ambulatory peritoneal dialysis (CAPD) in two cases, hemodialysis with extracorporeal ultrafiltration method (ECUM + HD) in one case and hemodiafiltration with continuous veno-venous hemofiltration (CVVHF + HDF) in one case for perioperative management. In each cases, intermittent HD was undergone during 4 days before operation. Intraoperatively, HD was used together with extracorporeal circulation. Blood pressure in the postoperative course changed more frequently in CAPD cases than ECUM + HD or CVVHF + HDF case. Especially, CVVHF + HDF stabilized the movement of circulation and kept balance of serum BUN, Cr after the operation (BUN; 27.2 +/- 6.3, Cr; 5.0 +/- 0.6). We concluded that CVVHF + HDF would be the most favorable method to maintain the fluid balance stably for the uremic patients after CABG.
Nakano
H
H
Department of Cardiovascular Surgery, Fukuyama Cardiovascular Hospital, Japan.
Shimakura
T
T
Katsumata
T
T
Shimamura
Y
Y
Yabuki
A
A
Matsuda
N
N
Yamaguchi
T
T
Kawakami
A
A
Ihashi
K
K
Sakamoto
T
T
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000601:surgery*; D001026:Coronary Artery Bypass; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011182:Postoperative Care; D006435:Renal Dialysis / Q000379:methods*