| Japanese |
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| Title | 高張マンニトール付加体外循環時の尿中電解質排泄及び腎機能について |
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| Subtitle | 原著 |
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| Authors | 中川美穂*, 田中義文**, 滝沢洋之*, 夏山卓**, 智原栄一**, 木下隆**, 平田誉*, 宮崎正夫*** |
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| Organization | *社会保険神戸中央病院麻酔科, **京都府立医科大学麻酔学教室, ***国立舞鶴病院 |
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| Journal | 循環制御 |
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| Volume | 12 |
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| Number | 1 |
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| Page | 77-83 |
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| Year/Month | 1991/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」17例の開心術症例において, 麻酔導入直後より15分あるいは30分毎に血清浸透圧・尿量・尿浸透圧の測定と, 尿中及び血中のナトリウム, カリウム, 尿素窒素及びクレアチニン濃度の測定を行った. マンニトール付加体外循環の影響を検討するために全てのデータをI期(体外循環移行前)及びII期(体外循環移行後及び離脱後)に分けた. 体外循環移行後, 血清浸透圧は移行前に比して有意に(p<0.05)増加した. クレアチニン・クリアランスにはI期とII期で有意差を認めなかった. 尿浸透圧は体外循環前の値に拘らず, 血清浸透圧値に近づき, ほぼ等張と(315.3〜372.1mOsm/)なった. 尿中ナトリウム, カリウム, 尿素窒素, クレアチニン濃度はすべて血清値に近づいた. I期におけるナトリウム排泄率は0.35〜1.49%, カリウム排泄率は9.8〜19.3%であったが, II期でしかも250〜400mOsm/lの等張尿が排泄されている間はそれぞれ4.7〜30.5%, 58.5〜110.9%と有意に(p<0.05)増加した. 高張マンニトール付加体外循環時には, 低体温及びマンニトールの影響により, 電解質, 及び水の再吸収阻害と尿の濃縮力障害が起こり, 原尿に近い尿の排泄による利尿が得られる. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | mannitol, cardiopulmonary bypass, electrolytes excretion, renal function, fractional excretion of sodium |
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| English |
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| Title | The effect of cardiopulmonary bypass with hyperosmotic mannitol on renal function and urinary electrolytes excretion |
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| Authors | Miho Nakagawa, Yoshifumi Tanaka, Hiroyuki Takizawa, Takashi Natsuyama, Ei-ichi Chihara, Takashi Kinoshita, Takashi Hirata, Masao Miyazaki |
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| Organization | Division of Anesthesia Shakai-Hoken Kobe Central Hospital, Department of Anesthesiology Kyoto Prefectural University of Medicine |
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| Journal | Circulation Control |
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| Volume | 12 |
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| Number | 1 |
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| Page | 77-83 |
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| Year/Month | 1991/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | The effect of cardiopulmonary bypass (CPB) with hyperosmotic mannitol on renal function and urinary electrolyte excretion was studied in 17 patients scheduled for open heart surgery. After the induction of anesthesia, plasma osmolality, urine volume, urine osmolality, plasma and urine concentrations of sodium, potassium, urea nitrogen and creatinine were measured every 15 or 30 minutes. All data were divided into two groups, Stage 1 (before CPB) and Stage 2 (during and after CPB). Urine volume increased during CPB, but there was no significant change of creatinine clearance. Urine osmolality approximated to the plasma osmolality regardless of the value before CPB. Concentrations of urine sodium, potassium, urea nitrogen and creatinine approximated to those of plasma. Excretion rates of sodium and potassium increased, but no significant change was observed in the rates of urea nitrogen and creatinine excretions. The fractional excretions of filtered sodium and potassium in Stage 1 were 0.35 to 1.49% and 9.8 to 19.3% respectively. In Stage 2, These values were 5 to 30% and 59 to 111% respectively. During CPB, almost iso-osmotic urine is excreted, and urinary electrolytes and solutes composition resembles that of plasma. Urine volume, urinary excretion rate of Na, and K and fractional excretions of filtered Na and K are markedly increased. These results suggest that mannitol and hypothermia inhibit reabsorption of electrolytes and water, which cause marked diuresis. |
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| Practice | Basic medicine |
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| Keywords | mannitol, cardiopulmonary bypass, electrolytes excretion, renal function, fractional excretion of sodium |
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