• Massimo Meco and Silvia Cirri.
• Cardiac Surgery and Anesthesia and Intensive Care Department, Instituto Clinico Sant'Ambrogio, Via Faravelli 16, 20171 Milan, Italy. massimo.meco@virgilio.it
• J. Cardiothorac. Vasc. Anesth. 2010 Feb 1;24(1):58-62.

ObjectiveThe purpose of this study was to evaluate the effect of 0.1 microg/kg/min of fenoldopam mesylate on renal flow and central hemodynamics measured by echocardiography in hemodynamically stable patients with preserved renal function undergoing cardiac surgery.DesignExperimental observational study.SettingSingle-institutional community hospital study.ParticipantsThirty patients undergoing cardiac surgery.InterventionFenoldopam mesylate infusion (0.1 microg/kg/min) in patients undergoing cardiopulmonary bypass.Measurements And Main ResultsDoppler measurements of renal blood flow and echocardiographic hemodynamic determinations after Doppler echocardiography measured flux velocities of the main, segmental, and interlobar and interlobular right renal arteries. The authors calculated the resistive index of all the renal segments studied. Moreover, the authors measured the flux of the main renal artery and its diameter as well as the main hemodynamic variables. All the measurements were performed in the intensive care unit setting at baseline and 20 minutes after the infusion of 0.1 microg/kg/min of fenoldopam mesylate. Fenoldopam mesylate infusion significantly increased blood flow in all renal compartments, thus improving the resistive index. The study showed that fenoldopam mesylate infusion does not induce any significant change of the heart rate or arterial pressure, cardiac output, preload, or wall stress.ConclusionsIn hemodynamically stable cardiac surgery patients with preserved renal function, an infusion of 0.1 microg/kg/min of fenoldopam mesylate has no influence on systemic hemodynamics while increasing renal blood flow.Copyright 2010 Elsevier Inc. All rights reserved.

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