Browsing by Author "Lema, G."

Now showing 1 - 3 of 3
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    Plasma levels of potassium and magnessium after modified ultrafiltration in pediatric cardiac surgery with cardiopulmonary bypass
    (SAGE PUBLICATIONS LTD, 2012) Lopez, R.; Lema, G.; Gonzalez, A.; Carvajal, C.; Canessa, R.; Carrasco, P.; Lazo, V.; Hudson, C.; Gonzalez, R.; Frangini, P.
    Objective: Modified ultrafiltration (MUF) reduces some of the complications associated with cardiopulmonary bypass (CPB) in pediatric cardiac surgery. However, we have observed hypokalemia and hypomagnesemia in children when MUF is used. Such alterations may elicit severe arrhythmias in the postoperative period. To date, no studies have focused on the effects MUF may have in plasma levels of potassium (K) and magnesium (Mg). The objective of our study was to determine if there is any variation in plasma levels of K (plK) and Mg (plMg) after MUF in children undergoing cardiac surgery with CPB.
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    RENAL FUNCTION IN THE PERIOPERATIVE PERIOD OF CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS, IN NEWBORNS WITH COMPLEX CONGENITAL HEART DISEASES: USE OF THE BIOMARKER KIM-1.
    (LIPPINCOTT WILLIAMS & WILKINS, 2016) Borchert, E.; Lema, G.; Jalil, R.; Guzman, A. M.; De la Fuente, R.; Gomez, M.; Fuentes, D.
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    Renal protection in patients undergoing cardiopulmonary bypass with preoperative abnormal renal function
    (LIPPINCOTT WILLIAMS & WILKINS, 1998) Lema, G.; Urzua, J.; Jalil, R.; Canessa, R.; Moran, S.; Sacco, C.; Medel, J.; Irarrazaval, M.; Zalaquett, R.; Fajardo, C.; Meneses, G.
    We prospectively studied the effects of renal protection intervention in 17 patients with preoperative abnormal renal function (plasma creatinine >1.5 mg/dL) scheduled for elective coronary surgery. Patients were randomized to either dopamine 2.0 ,mu g.kg(-1).min(-1) (Group 1, n = 10) or perfusion pressure >70 mm Hg during cardiopulmonary bypass (CPB) (Group 2, n = 7). Glomerular filtration rate and effective renal plasma flow were measured with inulin and I-125-hippuran clearances before the induction of anesthesia, after sternotomy and before CFB, during hypo-and normothermic CPB, after sternal closure, and 1 h postoperatively. Plasma and urine electrolytes were measured, and free water, osmolar, and creatinine clearances, as well as fractional excretion of sodium and potassium, were calculated ed before and after surgery. Significant differences between groups were found before CPB for glomerular filtration rate (higher in Group 1), urine output (2.0 vs 0.29 mL/min in Group 1 versus Group 2), urinary creatinine (66 vs 175 mg/dL), urinary osmolarity (370 vs 627 mOsm/L), osmolar clearance (2.1 vs 0.7 mL/min), and urinary potassium (33 vs 71 mEq/L). There were no differences between groups during hypo-and normothermic CPB. After CPB, the only difference was a slightly higher urinary creatinine in Group 2. Renal plasma flow was lower than normal in all patients before the induction of anesthesia. A nonsignificant trend toward increased flow was seen during hypothermic CPB. Filtration fraction was high before CPB, which suggests efferent arteriolar vasoconstriction, descending toward normal during and after CPB. The same pattern of changes was present in both groups. In conclusion, there were no clinically relevant differences between the two treatment modalities during and after CPB. However, significant differences were observed before CPB, when dopamine seemed to partially revert renal vasoconstriction. Implications: Two protective interventions were compared in patients undergoing heart surgery to prevent deterioration of renal function; these were dopamine infusion throughout the operation and phenylephrine infusion during cardiopulmonary bypass. We found clinically relevant differences only during surgery before cardiopulmonary bypass.