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2017 ; 7
(4
): e21740
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Evaluation of the Effect of Aminophylline in Reducing the Incidence of Acute
Kidney Injury After Cardiac Surgery
#MMPMID29696106
Shahbazi S
; Alishahi P
; Asadpour E
Anesth Pain Med
2017[Aug]; 7
(4
): e21740
PMID29696106
show ga
OBJECTIVES: Acute renal failure is a common complication of major cardiovascular
surgeries (One-third of patients). Adenosine release as a vascular vasodilator
increases after cardiac surgery, which reduces renal and glomerular blood flow
and subsequently causes kidney ischemic damage. The present study aimed at
evaluating the impact of aminophylline as an adenosine receptor antagonist on
renal function after cardiac surgery hoping to find an appropriate method to
reduce acute kidney injury. METHODS: The patients in the intervention group
received 5 mg/kg aminophylline bolus after induction of anesthesia; then, 0.25
mg/kg/hr of the drug was administered intraoperatively and up to 48 hours after
surgery in the ICU cardiac surgery. Similar volume of normal saline was injected
to the patients of the second group. Serum BUN, Cr, and GFR were measured pre-
and postoperatively and 3 days postsurgery. Patients' 24- hour urine output and
RIFLE were also calculated. RESULTS: Those patients who received medication were
extubated earlier (P = 0.018) and received lower amount of inotropic drugs (P <
0001). According to the RIFLE criteria, most of the patients experienced no
change or even improved GFR and Cr amounts compared to the control group (p <
0.05). GFR and Cr value of all the patients with Cleveland score, less and more
than 6, showed a significant difference between the 2 groups (P = 0.001 and P =
0.01, respectively). According to the RIFLE criteria, most of the patients
experienced no change or even improved GFR. CONCLUSIONS: Aminophylline in cardiac
surgery can reduce the frequency of acute kidney injury according to RIFLE
criteria and could be used in the prevention of AKI as a safe and efficient
modality in high-risk patients. Also, the use of this drug may reduce the need
for inotropic medication at the time of surgery, intensive care unit stay length,
and extubation time.