[Fenoldopam and kidney function in a case of abdominal aortic pseudoaneurysm with supra-renal clamping in an emergency protocol].
The renal haematic flow decrease, the vasoconstriction and the local vascular resistance increase, associated with descending aortic cross-clamping, before the origin of renal arteries, can be contrasted by continuous infusion of fenoldopam, a dopamine analog with selective action on DA1-receptors. The renal effects of this molecule are renal plasmatic flow increase and local vascular resistance decrease, without important haemodynamic changes, with mild cardiovascular modification, even at high doses, in hypertensive and non hypertensive patients, also in normal volume condition and hypovolemic condition. This selective action at renal level allows the use of fenoldopam also in surgical emergencies, in patients with low cardiovascular function. The case report here presented demonstrated a beneficial renal effects of continuous infusion of fenoldopam and its easy to use, in emergency situations. These findings could be extrapolated for other patients or suggested for additional research.
Caporelli
Sandro
S
Ospedale Torrette Istituto Emergenze Medico-Chirurgiche Via Conca 60020 Ancona.
Loggi
Silvia
S
Zompanti
Valeria
V
Romano
Rocco
R
Carbonari
Luciano
L
Alò
Francesco
F
Antognini
Marco
M
Pelaia
Paolo
P
D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control*; D017541:Aneurysm, False / Q000601:surgery*; D001012:Aorta, Abdominal / Q000601:surgery*; D001019:Aortic Rupture / Q000601:surgery*; D003250:Constriction; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004630:Emergencies; D018818:Fenoldopam / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D017447:Receptors, Dopamine D1 / Q000187:drug effects; D012079:Renal Circulation / Q000187:drug effects*
D018491:Dopamine Agonists; D017447:Receptors, Dopamine D1; D018818:Fenoldopam