Protective Effects of Cold Ringer's Solution Perfusion in Abdominal Aortic Surgery Requiring Renal Artery Clamp

In Vivo. 2020 Mar-Apr;34(2):739-744. doi: 10.21873/invivo.11833.

Abstract

Background/aim: Treating abdominal aortic aneurysms (AAA) of the juxtarenal artery with renal artery clamps burdens the kidneys. We investigated the outcomes of intra-operative renal artery perfusion using the cold Ringer's solution method for renal protection.

Patients and methods: We enrolled 290 AAA patients who underwent open aortic repair. Surgical outcomes were investigated based on renal protection.

Results: We evaluated 231 patients requiring infrarenal artery clamp (Group I), and 59 patients requiring perfusion in addition to the clamp (Group J). Patient demographics, acute kidney injury (AKI) incidence (Group I: 11.7% and Group J: 20.3%), hospital mortality (Group I: 1.3% and Group J: 1.7%), and 30-day mortality (Group I: 0.4% and Group J: 0%) were not different between the groups. The AKI incidence was low (13%) in cases requiring a renal artery clamp for ≥45 min (n=40).

Conclusion: Perfusion with cold Ringer's solution offers renal protection and may improve surgical outcomes.

Keywords: Juxtarenal abdominal aortic aneurysm; cold Ringer's solution perfusion; renal artery clamp; renal artery perfusion; renal protection.

MeSH terms

  • Acute Kidney Injury / complications*
  • Acute Kidney Injury / diagnosis
  • Aged
  • Aortic Aneurysm, Abdominal / complications
  • Aortic Aneurysm, Abdominal / surgery*
  • Cold Temperature
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Perfusion
  • Protective Agents / administration & dosage
  • Renal Artery / surgery*
  • Ringer's Solution / administration & dosage*
  • Risk Factors

Substances

  • Protective Agents
  • Ringer's Solution