Studies on the Massive Administration of Corticosteroid during Open Heart Surgery. Its Effect to Renal Function.

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The effects of the massive administration of dexamethasone on renal function during and after extracorporeal circulation have been studied clinically on sixty patients undergoing open heart surgery and experimentally on ten mongrel dogs undergoing total body perfusion, and the following results have been obtained: 1. Dexamethasone, given in massive doses, in-creases the urinary output during and after total body perfusion. The increased urinary volume is not due to water diuresis, but is due to solute diuresis. 2. One mg/kg of dexamethasone, given before perfusion, may be an adequate dose, but its effects on renal function might differ between children and adults. 3. Glomerular filtration rate and renal blood flow may be satisfactorily maintained during and after perfusion due to the decreased renal vascular resistance brought on by a massive administration of dexamethasone, although no significant difference could be clinically demonstrated. 4. Dexamethasone may act on the distal renal tubules, but, judging from the alterations of excreted electrolytes and osmolality in cases of massive administration, it may also effect the proximal renal tubules. 5. Dexamethasone may have no effect on the plasma antidiuretic hormone.
社団法人日本循環器学会の論文
1970-10-30