Artificial organs
-
Urinary excretion of selected markers for renal injury, as well as urinary excretion rates of the thromboxane metabolite, 11-keto-thromboxane B2 (11k-TXB2), was studied in 36 male patients undergoing coronary bypass surgery using cardiopulmonary bypass (CPB). In all patients, excretion of both tubular (N-acetyl-beta-D-glucosaminidase [beta NAG]; alpha 1-microglobulin [alpha 1-MG]) and glomerular markers (albumin [Alb]; transferrin [Trf]; immunoglobulin G [IgG]) sharply increased on Day 1 after CPB, and they remained elevated throughout the observation period of 5 days. Urinary excretion rates of 11k-TXB2 markedly increased on Day 1 after surgery, and they rapidly decreased thereafter. ⋯ Furthermore, no correlation between urinary excretion of 11k-TXB2 and any of the urinary markers for renal injury could be detected. Our data do not strengthen the hypothesis that acute renal injury observed during CPB is related to exaggerated thromboxane biosynthesis in these patients. Monitoring of urinary markers for incipient renal damage, particularly excretion of beta NAG, might be of additional diagnostic value for detection of otherwise subclinical renal injury in patients undergoing CPB.
-
We examined whether pyridoxalated hemoglobin-polyoxyethylene conjugate (PHP) could be life-relievable for carbon monoxide (CO) intoxication. Toxic gas (O2, 5.0%; CO2, 16.0%; CO, 1.8%; and N2, 77.2%) was inhaled by rabbits anesthetized with urethane and the following parameters were measured: blood pressure, arterial and venous Po2, Pco2, pH, and carboxyhemoglobin (COHb). When mean blood pressure reached 0 or 20 mm Hg as an index after inhalation of the toxic gas, the toxic gas was switched to air; intravenous infusion of physiological saline or PHP (1.2 g/20 ml/kg/30 min) was simultaneously initiated. ⋯ All 6 animals in the PHP group survived and each parameter recovered. PHP accelerated recovery from high COHb concentrations, low arterial and venous Po2, reduction of arterial and venous Pco2, and elevations of pH and blood pressure. These results suggest that PHP treatment during the early stage of CO intoxication is life-saving and effective in facilitating the recovery of various functions.