Key result
Prolonged isoflurane-induced hypotension preserved renal compensatory mechanisms, with renal function and hemodynamics quickly returning to normal upon resumption of normotension.
Why the study?
Does prolonged isoflurane-induced hypotension affect renal function and hemodynamics in human subjects?
Does prolonged isoflurane-induced hypotension affect renal function and hemodynamics in human subjects?
Renal compensatory mechanisms are preserved during prolonged isoflurane-induced hypotension, with rapid return to normal function upon resuming normotension.
Answers are grounded in this paper and cite their sources.
Does not support practice change; leaves open need for randomized confirmation of renal effects.
The effect of isoflurane-induced hypotension on glomerular function and renal blood flow was investigated in 20 human subjects. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured by inulin and para-aminohippurate (PAH) clearance, respectively. Anesthesia was maintained with fentanyl, nitrous oxide, oxygen, and isoflurane. Hypotension was induced for 236.9 +/- 15.1 min by increasing the isoflurane inspired concentration to maintain a mean arterial pressure of 59.8 +/- 0.4 mmHg. GFR and ERPF decreased with the induction of anesthesia but not significantly more during hypotension. Postoperatively, ERPF returned to preoperative values, whereas GFR was higher than preoperative values. Renal vascular resistance increased during anesthesia but decreased when hypotension was induced, allowing the maintenance of renal blood flow. We conclude that renal compensatory mechanisms are preserved during isoflurane-induced hypotension and that renal function and hemodynamics quickly return to normal when normotension is resumed.
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Lessard et al. (1991) studied this question. Isoflurane-induced hypotension vs. Baseline was evaluated on Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). Prolonged isoflurane-induced hypotension preserved renal compensatory mechanisms, with renal function and hemodynamics quickly returning to normal upon resumption of normotension.
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