Mp63-11 Raised Intrarenal Pressures Lead to Bacteraemia

You have accessJournal of UrologyStone Disease: Basic Research & Pathophysiology (MP63)1 May 2024MP63-11 RAISED INTRARENAL PRESSURES LEAD TO BACTERAEMIA Anne Hong, Marcel Leroi, Gregory S. Jack, and Damien M. Bolton Anne HongAnne Hong , Marcel LeroiMarcel Leroi , Gregory S. JackGregory S. Jack , and Damien M. BoltonDamien M. Bolton View All Author Informationhttps://doi.org/10.1097/01.JU.0001009436.52988.91.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Irrigation fluid is used during ureteroscopy and pyeloscopy to aid visualization during the procedure. However, this can result in raised intrarenal pressures (IRPs) which has been associated with peri-operative complications such as sepsis and increased pain. The exact mechanism of these complications is unknown. To explore this, we aim to demonstrate bacteraemia during raised IRPs. METHODS: Four deceased donor porcine kidneys were flushed with 1L heparinized saline and preserved on ice using a renal transplant protocol. The renal artery was cannulated with a 10Fr ureteric catheter and perfused continuously with 0.9% normal saline solution at mean arterial pressure of 90mmHg to simulate arterial blood flow. A steady state of venous effluent from the renal vein was achieved and collected continuously from the renal vein for the duration of the study. The ureter was cannulated with a 10Fr dual lumen ureteric catheter and the tip placed at the ureteropelvic junction and fixed in place with silk ties. A pressure monitor (Comet II Pressure Guidewire®, Boston Scientific, Massachusetts, USA) was inserted through one lumen and positioned in the renal pelvis for continuous renal pelvis irrigation pressure monitoring. An Escherichia coli broth diluted to a concentration of 1x106 colony forming units (CFU) was used as the irrigation fluid. This was infused under pressure through the ureteral access catheter at various IRPs to replicate pyeloscopy conditions. IRP was increased in increments of 15mmHg every 3-minutes and the venous effluent was collected at each increment. RESULTS: Figure 1 show the number of CFUs cultured following simulated ureteroscopy at increasing IRP. Wilcoxon rank test demonstrated that from 90mmHg onwards, the changes in CFU were statistically significant. CONCLUSIONS: E. coli was detected in the renal venous effluent renal pelvis irrigation pressures exceeded 60mmHg. This became statistically significant when IRP exceeded 90mmHg. Download PPT Source of Funding: Nil © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1035 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Anne Hong More articles by this author Marcel Leroi More articles by this author Gregory S. Jack More articles by this author Damien M. Bolton More articles by this author Expand All Advertisement PDF downloadLoading ...