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The effects of a single dose of furosemide on urine flow, fluid balance, and the course of plasma creatinine during cardiac surgery

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Introduction

Urine flow rate during cardiac surgery is frequently augmented with diuretics. Recent evidence has shown that a continuous infusion of low dose furosemide - starting before cardiopulmonary bypass (CPB) - has detrimental effects on renal function [1]. It is not known, if this does also apply to a single dose of a diuretic.

Methods

We performed a study to determine the effects of a single dose of furosemide - given immediately before or during CPB - on urine flow (UV), fluid balance and the course of plasma creatinine as a crude measure of renal function in patients subjected to coronary artery bypass grafting (CABG) procedures with CPB. Anesthesia charts from 1/01 to 3/01 were analysed retrospectively in alphabetical order until 24 patients had been selected that fulfilled the criteria: (a) isolated CABG procedure; (b) normal left ventricular function, and (c) no need for inotropes during surgery.

Results

Urine flow (UV), infused fluids and plasma creatinine values PCREA (mean ± SEM) are given in Table 1. Three patients - all in the diuretics group - received transfusion of packed red cells. Subgroup analysis excluding these patients revealed that relative PCREA was significantly higher (P < 0.05) after CPB in the diuretics group in comparison with control.

Table 1 Table 1

Conclusions

These retrospective data suggest that a single dose of furosemide during cardiac surgery does have no beneficial effects on the course of PCREA and UV but conversely may lead to a greater need of fluids and to a trend to more blood transfusions and a deterioration of renal function.

References

  1. 1.

    Lassnigg A, et al.: J Am Soc Nephrol 2000, 11: 97-104.

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Heringlake, M., Klaus, S., Bahlmann, L. et al. The effects of a single dose of furosemide on urine flow, fluid balance, and the course of plasma creatinine during cardiac surgery. Crit Care 6, P176 (2002). https://doi.org/10.1186/cc1636

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Keywords

  • Renal Function
  • Single Dose
  • Coronary Artery Bypass Grafting
  • Furosemide
  • Cardiopulmonary Bypass