title: Intrarenal pressures remain low with placement of a dual lumen catheter for retrograde irrigation to induce renal hypothermia.
abstract: OBJECTIVE
  To determine whether placement of a 10 French dual lumen catheter produces a low-pressure collecting system during retrograde irrigation to induce renal hypothermia. Indication for the study is as a potential adjunct for partial nephrectomy.
  
  
  METHODS
  Ex vivo porcine kidneys underwent harvest, and a ureteral catheter (either single lumen or dual lumen) was placed in the ureter within the renal pelvis. Pressure measurements (n = 1,080) were recorded at 1-s intervals. Irrigant flow rates were initiated at gravity and subsequently increased at 10 cc/min increments to a maximum of 100 cc/min.
  
  
  RESULTS
  During retrograde infusion without a dual lumen catheter, every 10 cc/min rate increase resulted in an 8 cm H(2)O rise in intrarenal pressure. The maximum flow rate obtained was 20 cc/min before urinary extravasation or intrarenal drainage occurred. Maximum pressure obtained before urinary extravasation or collecting system perforation was 16 cm H(2)O. Placement of a dual lumen catheter within the renal pelvis allowed intrarenal pressures to remain less than 5 cm H(2)O (when infusion rates <80 cc/min). The maximum flow rate while maintaining pressures <20 cm H(2)O was 90 cc/min. Flow rates above 100 cc/min resulted in urinary extravasation. The maximal flow rate that is safe for collecting systems with a dual lumen catheter is 80 cc/min, and without a dual lumen catheter rates greater than 20 cc/min resulted in collecting system perforations.
  
  
  CONCLUSIONS
  Using an ex vivo porcine model, application of a 10 French ureteral dual lumen catheter produced adequate retrograde drainage that resulted in low intrarenal pressures at high infusion rates (up to 80 cc/min).
authors.affiliation: Department of Urology, Tulane University School of Medicine, 1430 Tulane Avenue, SL-42, Room 3522, New Orleans, LA 70112, USA. jcolli.tulane@gmail.com
authors.forename: J
authors.initials: J
authors.lastname: Colli
authors.forename: K
authors.initials: K
authors.lastname: Cotter
authors.forename: P
authors.initials: P
authors.lastname: Dorsey
authors.forename: G
authors.initials: G
authors.lastname: Mitchell
authors.forename: B R
authors.initials: BR
authors.lastname: Lee
mesh_terms: D000818:Animals; D057785:Catheters; D050377:Cold Ischemia; D007036:Hypothermia, Induced / Q000295:instrumentation*; D007668:Kidney; D011312:Pressure; D012965:Sodium Chloride / Q000008:administration & dosage; D013552:Swine; D007507:Therapeutic Irrigation / Q000295:instrumentation*
chemical_list: D012965:Sodium Chloride