RENAL FUNCTION— MOVER. ^[ORRIS axd DE BAKEY 



211 



-Anesthesia ■ 



Renal and Aortic 



160 



c 140 



I 



Sl20 



I 



I 100 

 I 80 



< 60 



I 40 

 o 



20f' 

 



HI 98 B'-t 



^^Renol Blood Flow 



^^ Glomerulor Filtration Rote 



purine Volume 



i^ 



K\\-^g~-| I . CTT^^': 



9am 10 II 



12 

 noon 



7pm One week 



Fig. 12. — The effect of anesthesia, hypothermia and prolonged ischemia of the kidney under 

 hypothermia during surgical homographic replacement of the aorta. 



During aortic and renal artery occlusion there was no measurable renal function. 

 After rewarming, an extreme depression in both renal function and water ex- 

 cretion was oljserved. One week following operation, extreme de]:)ression in l)oth 

 renal blood flow and glomerular filtration rate persisted due to the severe renal 

 damage which occurred during occlusion of the renal arteries and aorta. Urine 

 volume at this time was increased, which prol)ably reflects tubiflar damage with 

 failure of concentration. 



Case 2. — A 54-year-old white male had a dissecting aneurysm involving the 

 descending thoracic aorta. He was cooled to a temperature of 89° F. with refriger- 

 ation blankets. The point of dissection began jusj: distal to the left subclavian artery 

 and extended below the diaphragm. A portion of the descending thoracic aorta was 

 resected and replaced with a lyophilized homograft. The period of aortic occlusion 

 was S3 minutes. 



As presented in tal)le II the control values for this patient show moderate hyper- 



TABLE II 

 Renal Hemodyxamic Response to Hypothermia and Aortic Occlusion 



Renal (ilfunenilar 



Blood blood filtration Urine 



pressure flow rate volume 



(mm. Hg) (ml/niin.) (ml/min.) (ml/min.) 



Control observations (99° F.) 160/100 1126 109 .4 



Anesthesia (pentothal ) 150/100 1175 139 1.6 



Hypothermia (94° F. ) 130/90 1026 95 5.6 



Hypothermia (89° F.) 100/70 985 81 2.4 



Aortic occlusion (89° E. ) 100/80 27 1 0.1 



After occlusion (89° E.) 130/80 545 25 1.1 



Rewarmed (98° F. ) 200/90 866 82 2.7 



After 7 (lays (98° F.) 172/102 771 91 2.1 



