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Effect of intraoperative dexmedetomidine on renal function after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a randomized, placebo-controlled trial

Authors
 Young Song  ;  Do-Hyeong Kim  ;  Tae Dong Kwon  ;  Dong Woo Han  ;  Seung Hyuk Baik  ;  Hwan Ho Jung  ;  Ji Young Kim 
Citation
 International Journal of Hyperthermia, Vol.36(1) : 1-8, 2019 
Journal Title
 International Journal of Hyperthermia 
ISSN
 0265-6736 
Issue Date
2019
Keywords
Cytoreductive surgical procedures ; acute kidney injury ; dexmedetomidine ; hyperthermia
Abstract
INTRODUCTION: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) predispose to postoperative renal dysfunction. Dexmedetomidine is an α2 adrenoreceptor agonist, which has renoprotective effects after cardiac surgery. OBJECTIVE: To assess the effect of dexmedetomidine on renal function after CRS and HIPEC. MATERIALS: Thirty-eight patients undergoing CRS and HIPEC were randomized to receive dexmedetomidine (dexmedetomidine group, n = 19, loading 1 μg/kg over 20 min followed by infusion at 0.5 μg/kg/h) or 0.9% sodium chloride (control group, n = 19) during surgery. Creatinine clearance (CrCl) was assessed daily until postoperative day 7. Urine neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule (KIM)-1 were measured for 24 h after surgery. RESULTS: There was no difference in the lowest CrCl value during the first 7 days postoperatively, but the % change from baseline to the lowest value was lower in the dexmedetomidine group than in the control group (p = .037). Urine NGAL and KIM-1 levels were increased over time in both groups, but the increases were significantly less in the dexmedetomidine group (p = .018 and 0.038, respectively). In the dexmedetomidine group, the length of intensive care unit stay was shorter (p = .034). CONCLUSIONS: Intraoperative dexmedetomidine infusion did not improve renal function in terms of serum Cr-related indices following CRS and HIPEC. However, as the decrease in CrCl was attenuated and early tubular-injury markers were lower in the dexmedetomidine group, dexmedetomidine may have protective effects against early tubular injury in CRS and HIPEC. Clinical Trials Registry: http://clinicaltrials.gov (NCT02641938).
Full Text
https://www.tandfonline.com/doi/full/10.1080/02656736.2018.1526416
DOI
10.1080/02656736.2018.1526416
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kweon, Tae Dong(권태동) ORCID logo https://orcid.org/0000-0002-5451-1856
Kim, Do Hyeong(김도형) ORCID logo https://orcid.org/0000-0003-2018-8090
Kim, Ji Young(김지영) ORCID logo https://orcid.org/0000-0001-5822-0338
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Song, Young(송영) ORCID logo https://orcid.org/0000-0003-4597-387X
Jung, Hwan Ho(정환호) ORCID logo https://orcid.org/0000-0002-3819-2744
Han, Dong Woo(한동우) ORCID logo https://orcid.org/0000-0002-8757-663X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/167762
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