Effects of enalaprilat infusion on hemodynamics and renal function in patients undergoing cardiac surgery.
OBJECTIVE
This study was undertaken to evaluate the effect of enalaprilat infusion on hemodynamics and renal function during cardiopulmonary bypass (CPB).


METHODS
Thirty adults undergoing CPB were randomly allocated into 2 groups. All patients received the same anesthetic protocol and same dopamine infusion protocol (2 mg/kg(-1)/min(-1)) during the study. In addition to dopamine infusion 15 patients received enalaprilat infusion (0.06 mg/kg(-1)/hr(-1)) during CPB. Blood creatinine, urea levels, and creatinine clearance (CLcr) were measured and cardiac output (CO) was calculated by echocardiography preoperatively and on the 6th postoperative day. Mean arterial pressure (MAP), central venous pressure (CVP), systemic vascular resistance (SVR) measurements were recorded during the operation and during postoperative 24 hours.


RESULTS
In the control group postoperative blood creatinine and urea levels were significantly higher and CLcr measurements were significantly lower than the preoperative values (p<0.05). These values did not change in the enalaprilat group. Mean arterial pressure was similar in both groups (p>0.05), but SVR was lower (p<0.05) and CVP was higher (p<0.05) in the enalaprilat group than in the control group. In the enalaprilat group postoperative CO measurements were higher than the preoperative values (p<0.05).


CONCLUSIONS
Our results demonstrate that enalaprilat infusion during CPB improves renal function and CO measurements in the early postoperative period.
Türker
Handan
H
Department of Anesthesiology, University of Baskent, School of Medicine, Ankara, Turkey.
Dönmez
Asli
A
Zeyneloğlu
Pinar
P
Sezgin
Atilla
A
Uluçam
Melek
M
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D002302:Cardiac Output / Q000187:drug effects; D002315:Cardiopulmonary Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D003404:Creatinine / Q000097:blood; D015773:Enalaprilat / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014463:Ultrasonography; D014508:Urea / Q000097:blood
D000806:Angiotensin-Converting Enzyme Inhibitors; D014508:Urea; D003404:Creatinine; D015773:Enalaprilat