دورية أكاديمية
Intra-arterial nitroglycerin for intra-operative arterial vasospasm during pediatric renal transplantation.
العنوان: | Intra-arterial nitroglycerin for intra-operative arterial vasospasm during pediatric renal transplantation. |
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المؤلفون: | Penna FJ; Division of Paediatric Urology, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada., Harvey E; Division of Nephrology, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada., John P; Division of Radiology, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada., Armstrong D; Division of Radiology, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada., Luginbuehl I; Division of Anesthesia, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada., Odeh RI; Division of Paediatric Urology, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada., Alyami F; Division of Paediatric Urology, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada., Koyle MA; Division of Paediatric Urology, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada., Lorenzo AJ; Division of Paediatric Urology, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada. |
المصدر: | Pediatric transplantation [Pediatr Transplant] 2016 May; Vol. 20 (3), pp. 463-6. Date of Electronic Publication: 2016 Feb 21. |
نوع المنشور: | Case Reports; Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Munksgaard Country of Publication: Denmark NLM ID: 9802574 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-3046 (Electronic) Linking ISSN: 13973142 NLM ISO Abbreviation: Pediatr Transplant Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Copenhagen ; Malden, MA : Munksgaard, c1997- |
مواضيع طبية MeSH: | Injections, Intra-Arterial* , Kidney Transplantation*, Coronary Vasospasm/*drug therapy , Coronary Vasospasm/*etiology , Kidney Failure, Chronic/*surgery , Nitroglycerin/*administration & dosage , Polycystic Kidney, Autosomal Recessive/*surgery, Allografts ; Child, Preschool ; Female ; Hemodynamics ; Humans ; Intraoperative Period ; Perfusion ; Renal Artery ; Treatment Outcome ; Ultrasonography, Doppler ; Vasodilator Agents/administration & dosage |
مستخلص: | Intra-operative arterial vasospasm during pediatric renal transplantation is an urgent clinical situation resulting in end-organ ischemia, associated changes in parenchymal turgor and color, diminished flow on ultrasound, and if left untreated, allograft loss. We hypothesized that intra-operative intra-arterial injection of nitroglycerin would reverse vasospasm and improve renal perfusion. A three-yr-old girl with end-stage renal disease due to autosomal recessive polycystic kidney disease on peritoneal dialysis underwent deceased donor renal transplantation. After optimal immediate reperfusion and hemodynamic parameters, the kidney lost turgor and became mottled in appearance despite adequate hilar arterial and venous Doppler waveforms. Two aliquots of 40 μg (0.4 mL of a 100 μg/mL) nitroglycerin solution were injected directly into the renal artery 10 min apart. Nitroglycerin resulted in dramatic change in the consistency and appearance of the allograft. An improvement in renal blood flow was demonstrated by ultrasound after the second intra-arterial nitroglycerin injection with only a transient decrease in systemic arterial blood pressure. The child experienced normal allograft perfusion on serial postoperative ultrasounds, with a prompt decrease in serum creatinine and excellent diuresis. Intra-arterial nitroglycerin is a promising option for intra-operative arterial vasospasm during pediatric renal transplantation with objective improvement in blood flow and perfusion. (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.) |
فهرسة مساهمة: | Keywords: intra-arterial injections; kidney transplantation; nitroglycerin; pediatrics |
المشرفين على المادة: | 0 (Vasodilator Agents) G59M7S0WS3 (Nitroglycerin) |
تواريخ الأحداث: | Date Created: 20160223 Date Completed: 20170303 Latest Revision: 20170303 |
رمز التحديث: | 20231215 |
DOI: | 10.1111/petr.12688 |
PMID: | 26899590 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1399-3046 |
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DOI: | 10.1111/petr.12688 |