Anesthesia and renal considerations:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
2000
|
| Series: | Anesthesiology clinics of North America
18,4 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XVI S., S. 705 - 994 Ill., graph. Darst. |
Staff View
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| 650 | 4 | |a Anesthesia |x Complications | |
| 650 | 4 | |a Chronic renal failure | |
| 650 | 4 | |a Kidney Diseases |x surgery | |
| 650 | 4 | |a Kidney Failure | |
| 650 | 4 | |a Oliguria | |
| 650 | 4 | |a Postoperative Complications | |
| 650 | 4 | |a Renal pharmacology | |
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| adam_text | ANESTHESIA AND RENAL CONSIDERATIONS
CONTENTS
Foreword xiii
Jonathan L. Benumof
Preface xv
Jerome F. O Hara, Jr
The Patient at Risk for Acute Renal Failure:
Recognition, Prevention, and Preoperative Optimization 705
B. Craig Weldon and Terri G. Monk
Postoperative acute renal failure (ARF) is a serious complication
resulting in a prolonged hospital stay and increased morbidity
and mortality. Patients may be at risk for this problem because of
an underlying medical condition, the scheduled surgical proce¬
dure, nephrotoxin exposure, or a combination of these factors.
Among the strategies that can be used to prevent postoperative
ARF are optimization of intravascular volume status, invasive
hemodynamic monitoring, avoidance of nephrotoxic medications,
and proper spacing of procedures associated with the potential
for renal damage. Although numerous pharmacologic regimens
have been suggested for renal protection, their efficacy is largely
unproven.
Intraoperative Management of Renal Function in the
Surgical Patient at Risk: Focus on Aortic Surgery 719
Peter K. Schoenwald
Certain surgical procedures put the patient at high risk for post¬
operative renal dysfunction including aortic surgery. Should renal
failure develop, the associated mortality rate is high. Various
interventions have been used as a prophylactic measure to elimi
ANESTHESIOLOGY CLINICS OF NORTH AMERICA
VOLUME 18 • NUMBER 4 • DECEMBER 2000 vii
nate or attenuate the insult to the kidney. Unfortunately, many
pharmacologic interventions are based on empiricism rather than
fact. It seems that the data do not substantiate a definitive prophy¬
lactic effect in this clinical scenario. The various interventions are
examined, and it appears that volume loading and maintenance
of an adequate volume status are the only maneuvers that clearly
can make a difference in outcome.
Oliguria in the ICU: Systematic Approach to Diagnosis
and Treatment 739
Robert N. Sladen
Perioperative oliguria is common but rarely implies acute renal
failure. We should interpret oliguria as a sign of intravascular
hypovolemia and treat it as prerenal until proven otherwise. On
the other hand, the absence of oliguria does not exclude acute
renal failure. The most reliable clinical indicator of progressive
renal dysfunction is a serial decline in creatinine clearance estima¬
tion, a measure of glomerular filtration rate.
New Pharmacologic Options for Renal Preservation 753
Susan Garwood
Perioperative renal failure continues to be a significant source
of morbidity and mortality after high risk surgery. In order to
understand the rationale for some of the more novel pharmaco¬
logic agents proposed for renal protection, traditional and newer
concepts in the etiology and pathophysiology of perioperative
renal failure are briefly reviewed. The scientific basis for the
investigation of individual agents as renoprotective modalities is
presented along with available and supporting clinical data.
Pathophysiology and Management of Renal
Insufficiency in the Perioperative and Critically 111
Patient 773
Michelle L. Hladunewich and Myer H. Rosenthal
Acute renal failure remains a common, devastating complication
of the postoperative period and in the critically ill patient. The
most common cause is the progression of prerenal insufficiency
to acute tubular necrosis. Despite improved understanding of
the pathogenic mechanisms including impaired hemodynamic
autoregulation, medullary hypoxia, and proximal tubular obstruc¬
tion and translubular backleak, the treatment to date remains
largely supportive. Ensuring hemodynamic stability with provis¬
ions of adequate renal perfusion provides the best means for
minimizing the complications of this organ dysfunction.
viii CONTENTS
Renal Blood Flow Regulation, Autoregulation, and
Vasomotor Nephropathy 791
Robert N. Sladen and Donald Landry
Renal blood flow and renal perfusion pressure are regulated by
two control mechanisms. The first, extrinsic, actually involves
a complex interaction of vasomotor effects between opposing
neurohormonal systems. The second, intrinsic mechanism, renal
autoregulation, depends on changes in afferent arteriolar tone in
response to the renal perfusion pressure itself. This article reviews
these two mechanisms, how they normally respond to stress, and
the clinical implications of certain situations in which these con¬
trol mechanisms are disrupted.
Physiologic Acid Base and Electrolyte Changes in Acute
and Chronic Renal Failure Patients 809
Donald S. Prough
Patients with acute and chronic renal failure are vulnerable to a
wide variety of acid base and electrolyte disturbances. The variety
is related not only to predictable disturbances that arise as a
consequence of impaired urinary excretion, but also to associated
factors, such as intercurrent disease processes, chronic medica¬
tions, and renal replacement therapy. This article emphasizes
the pathogenesis, diagnosis, and treatment of common problems,
including metabolic acidosis, hyponatremia, hypernatremia, hy
perkalemia, hyperphosphatemia, and hypocalcemia.
Low Dose Renal Dopamine 835
Jerome F. O Hara, Jr
Low dose renal dopamine continues to be infused in patients at
risk for renal dysfunction or as a therapy after acute renal failure
has been established. This article reviews the impact of acute
renal failure on patients and reviews the history and use of
dopamine therapy for patients. A discussion of the rationale,
positive and equivocal evidence, side effects, and possible clinical
indications for low dose renal dopamine therapy is included.
Dialysis 101: Acute and Chronic Fluid Shifts 853
Samuel A. Irefin
For over 30 years, dialysis has been accepted as a proven thera¬
peutic intervention in sustaining life for patients with end stage
renal disease. As a renal replacement therapy, dialysis only ap¬
proximates renal function. Derangements in fluids, electrolytes,
and acid base homeostasis occur in the course of progressive
renal insufficiency. Nephrons are able to adapt to physiologic
needs and maintain a balance for many solutes, until the very
CONTENTS ix
late stages of chronic renal failure. This permits survival of the
patient with minimal therapeutic intervention. The availability
of highly permeable membranes has allowed development of
continuous renal replacement therapies that gradually remove
fluids and solutes resulting in better hemodynamic stability.
Anesthetic Considerations for the Patient With Renal
Failure 863
Robert N. Sladen
Patients in end stage renal disease and chronic liver failure pre¬
sent a number of challenges to the anesthesiologist. They may be
chronically ill and debilitated and have the potential for multisys¬
tem organ dysfunction. To safely manage these patients we need
to understand the benefits and limitations of dialysis and the
altered pharmacology of commonly used anesthetic agents and
perioperative medications in chronic renal failure.
Transurethral Resection of the Prostate 883
Vinod Malhotra
Transuretheral resection of prostate (TURP) is a common opera¬
tion in most hospitals. The patients are elderly and usually have
concomitant diseases such as diabetes, hypertension, cardiac and
respiratory ailments that increase their perioperative risk. Periop¬
erative morbidity and mortality approaches 20% and 1% respec¬
tively. Regional anesthesia, notably spinal anesthesia, offers many
advantages over general anesthesia for TURP with some evidence
of lower morbidity even though similar mortality rates and over¬
all outcomes are reported for both groups. Procedure specific
complications include TURP syndrome, bladder perforation, pri¬
mary fibrinolysis, bacteremia, and septicemia. All are associated
with significant morbidity and mortality but amenable to early
and aggressive therapeutic intervention.
Anesthesia for Radical Prostatectomy, Cystectomy,
Nephrectomy, Pheochromocytoma, and Laproscopic
Procedures 899
David G. Whalley and Michael J. Berrigan
This article presents some of the more salient aspects of the
anesthetic management of the common major renal surgical pro¬
cedures and discusses the physiology and anesthetic implications
of minimally invasive laparoscopic urologic surgery.
Anesthesia for Kidney Transplant Surgery 919
Juraj Sprung, Leonardo Kapural, Denis L. Bourke,
and Jerome F. O Hara, Jr
Organ viability with renal transplantation is a product of manag¬
ing the donor patient, the allograft, and the recipient patient. The
X CONTENTS
function and viability of the transplanted kidney appear to be
optimized if graft perfusion is maximized through mild hypervo
lemia using albumin, mannitol, and a calcium channel blocker
perioperatively. Careful balancing of these requirements against
co morbid conditions, especially cardiovascular problems, is nec¬
essary. The anesthesiologist implementing these measures can
contribute significantly to the short term and long term success
of renal transplants.
Extracorporeal Shock Wave Lithotripsy and
Percutaneous Nephrolithotomy 953
Dietrich Gravenstein
This article reviews the basic anesthetic considerations for extra
corporeal shock wave lithotripsy and percutaneous nephrolithot¬
omy. General principles governing the operation of lithotripters,
elements of treatment that impinge on safety, and effective intra
operative anesthesia and complications that may be encountered
in the perioperative period are discussed. Factors influencing
blood loss and concerns arising from positioning patients prone
are addressed in the sections devoted to percutaneous nephro¬
lithotomy.
Cumulative Index 2000 973
Subscription Information Inside back cover
CONTENTS xi
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| spelling | Anesthesia and renal considerations Jerome F. O'Hara guest ed. Philadelphia [u.a.] Saunders 2000 XVI S., S. 705 - 994 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Anesthesiology clinics of North America 18,4 Anesthésie - effets indésirables Défaillance rénale aigüe Acute renal failure Anesthesia Anesthesia Complications Chronic renal failure Kidney Diseases surgery Kidney Failure Oliguria Postoperative Complications Renal pharmacology Surgery Complications Transurethral Resection of Prostate Narkoserisiko (DE-588)4218722-9 gnd rswk-swf Nierenkrankheit (DE-588)4075399-2 gnd rswk-swf Anästhesie (DE-588)4001833-7 gnd rswk-swf Risikopatient (DE-588)4126574-9 gnd rswk-swf Niere (DE-588)4042270-7 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Niere (DE-588)4042270-7 s Anästhesie (DE-588)4001833-7 s DE-604 Nierenkrankheit (DE-588)4075399-2 s Risikopatient (DE-588)4126574-9 s Narkoserisiko (DE-588)4218722-9 s O'Hara, Jerome F. Sonstige oth Anesthesiology clinics of North America 18,4 (DE-604)BV000600896 18,4 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009203981&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Anesthesia and renal considerations Anesthesiology clinics of North America Anesthésie - effets indésirables Défaillance rénale aigüe Acute renal failure Anesthesia Anesthesia Complications Chronic renal failure Kidney Diseases surgery Kidney Failure Oliguria Postoperative Complications Renal pharmacology Surgery Complications Transurethral Resection of Prostate Narkoserisiko (DE-588)4218722-9 gnd Nierenkrankheit (DE-588)4075399-2 gnd Anästhesie (DE-588)4001833-7 gnd Risikopatient (DE-588)4126574-9 gnd Niere (DE-588)4042270-7 gnd |
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| title | Anesthesia and renal considerations |
| title_auth | Anesthesia and renal considerations |
| title_exact_search | Anesthesia and renal considerations |
| title_full | Anesthesia and renal considerations Jerome F. O'Hara guest ed. |
| title_fullStr | Anesthesia and renal considerations Jerome F. O'Hara guest ed. |
| title_full_unstemmed | Anesthesia and renal considerations Jerome F. O'Hara guest ed. |
| title_short | Anesthesia and renal considerations |
| title_sort | anesthesia and renal considerations |
| topic | Anesthésie - effets indésirables Défaillance rénale aigüe Acute renal failure Anesthesia Anesthesia Complications Chronic renal failure Kidney Diseases surgery Kidney Failure Oliguria Postoperative Complications Renal pharmacology Surgery Complications Transurethral Resection of Prostate Narkoserisiko (DE-588)4218722-9 gnd Nierenkrankheit (DE-588)4075399-2 gnd Anästhesie (DE-588)4001833-7 gnd Risikopatient (DE-588)4126574-9 gnd Niere (DE-588)4042270-7 gnd |
| topic_facet | Anesthésie - effets indésirables Défaillance rénale aigüe Acute renal failure Anesthesia Anesthesia Complications Chronic renal failure Kidney Diseases surgery Kidney Failure Oliguria Postoperative Complications Renal pharmacology Surgery Complications Transurethral Resection of Prostate Narkoserisiko Nierenkrankheit Anästhesie Risikopatient Niere Aufsatzsammlung |
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