Villegas-Anzo F, Castellanos-Olivares A, Gracida-Juárez C, Rangel-Montes MA, Espinoza-Pérez R, Cancino-López J

Language: Spanish
References: 20
Page: 50-57
PDF size: 232.30 Kb.

ABSTRACT

Introduction: The kidney transplantation is the therapeutic alternative to improve the quality of the patient’s life with chronic renal insufficiency; the anesthesiologist should be take account the characteristic physiopathology for the prevention of the complications perioperative that include four general conditions: hyperkalemia, metabolic acidosis, hypertension and azotemia. The hyperkalemia represents the most important ionic disorder to correct in the treatments of urgency; the evaluations in the literature have demonstrated that the infusion of glucose hypertonic (polarizing solution) with insulin is more effective than (conventional treatment) with bicarbonate, gluconate of calcium and hyperventilation. Objectives: To demonstrate that the decrease of the values on plasma of potassium is bigger when administers himself bicarbonate, gluconate of calcium and hyperventilation in comparison with glucose hypertonic and insulin. Design: Prospective, comparative and cuasiexperimental study. Material and methods: 54 patients were studied with levels subjected high plasma potassium concentrations to surgery of kidney transplantation from January 1990 to December 1997. Results: Were formed two groups, one managed with conventional treatment and other with glucose hypertonic with insulin treatment 30 patients were formed managed with conventional treatment being reported levels plasma of K in 6.29 ± 0.43 mEq/L the treatment preoperative was 91.7% of patients with dialysis and 8.3% with hemodialysis, with age average 33 ± 8.8 years, weight 55 ± 9.9 kg. Group II: solution glucose and insulin the initial levels of K was 7.01 ± 0.66 with descent up to 4.39 ± 0.74 mEq/L, the treatment perioperative it was the peritoneal dialysis in 23 patients (76.7%) and seven with hemodialysis (23.3%), with average 36 ± 14 years and weight 52 ± 13.7 kg. Conclusions: The subjected patients to treatment with glucose an insulin had bigger descent of the levels plasma of K without tendency to their increase that with the conventional treatment of bicarbonate, hyperventilation and gluconate of calcium.

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