Prevention of renal insufficiency after abdominal aortic aneurysm resection by optimal volume loading
H. L. Bush Jr, J. B. Huse, W. C. Johnson, E. T. O'Hara and D. C. Nabseth
A retrospective case review of 34 men was undertaken to evaluate the
relationship between preoperative volume loading and renal function before,
during, and after abdominal aortic aneurysm surgery. Volume expansion was
guided by either central venous pressure (CVP) in 12 patients or pulmonary
artery wedge pressure (PAWP) measurements in 22 patients. Statistically
significant differences (P less than .05) were noted between the two groups
where greater preoperative volume loading and urine output were associated
with lower postoperative serum creatinine and renal function indices in the
PAWP group. The age range, vascular risk factors, aneurysm size, and
preoperative renal function were similar. The data indicate that (1) PAWP
is a more accurate monitor for volume expansion than CVP and (2) when
volume replacement is optimal, abdominal aortic aneurysm surgery is not
associated with postoperative renal insufficiency.
