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January 1964

Urine Volume and Osmolality: A Consideration in Patients Undergoing Surgery With and Without Extracorporeal Circulation

Author Affiliations

From the Department of Surgery, Western Reserve University School of Medicine and the Cleveland Metropolitan General Hospital.

Arch Surg. 1964;88(1):155-162. doi:10.1001/archsurg.1964.01310190157018

Renal failure occasionally complicates maintenance of the circulation and respiration by extracorporeal means. Beall et al,1 in 1957, studied the renal function in eight of 98 patients subjected to surgery with the aid of cardiopulmonary bypass and reported a transient depression of renal function during perfusion. More recently, Doberneck2 reported an analysis of 1,000 patients undergoing open-heart surgery with the use of cardiopulmonary bypass. The over-all incidence of renal failure postoperatively was 3%, and the mortality in this group was 86.7%. Yeh et al3 observed that 80% of 153 consecutive patients undergoing open-heart surgery had abnormal urinary sediment postoperatively, while only 16 or 10.5%, developed postoperative renal complications. One patient died of fatal renal failure. The number of patients who die of this particular complication of open-heart surgery is not great, but this group is an example of a theoretically preventable complication. Among the etiologic factors considered

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