Renal failure
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This article reviews our experience with 111 pediatric patients following open-heart surgery over 1-year period. Peritoneal dialysis was required in 34 of 111 children (30.6%). We randomly selected 33 patients who did not require peritoneal dialysis as control group. ⋯ In conclusion in children high mortality rate following open-heart surgery was associated with ARF. Patients with cyanotic congenital heart disease and prolonged cardiopulmonary bypass time are at risk for ARF. The presence of these factors can be predicted in the early institution of peritoneal dialysis after cardiac surgery.
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There is increasing evidence indicating that the distant organ injury is a major contributor of high mortality in patients subjected to acute renal failure (ARF). However, sources and mechanisms that ARF causes distant organ injury remain to be determined. The aim of this study is to explore the mechanism from polymorphonuclear neutrophil (PMN) sequestration and membrane pump suppression. ⋯ Membrane pump activities of kidney in two model groups are significantly lower than the control group at multiple time points. Moreover, Na(+)-K(+)-, Ca(2+)-, Mg(2+)-, and Ca(2+)-Mg(2+)-ATPase activities of myocardium and pancreas in two model groups are gradually declined with the development of ARF. These findings suggest that PMN sequestration and membrane pump suppression plays an important role in the pathogenesis of ARF and also a major mechanism of myocardium and pancreas injury during the process of ARF.
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Ischemia/reperfusion (I/R) occurs in a number of pathological conditions, including myocardial infarction, stroke, aortic surgery, cardiopulmonary bypass surgery, organ transplantation, resuscitation, and critical care. Massive and abrupt release of oxygen-free radicals after reperfusion triggers oxidative damage. Before critical operations or after resuscitation, it would be wise to find a suitable prophylactic treatment to avoid I/R damage. We aimed to determine whether several commonly used intravenous anesthetics protect against renal I/R injury. ⋯ Thiopental and propofol, especially thiopental, are more effective to protect renal I/R injury.