Acute effects of furosemide and mannitol on renal function in the early postoperative period

Per-Olof Järnberg, J. Eklund, P. O. Granberg

Research output: Contribution to journalArticle

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Abstract

The effects of furosemide and mannitol on renal function in the immediate post-operative period were studied in 16 patients, who had undergone upper abdominal surgery under neurolept anaesthesia. Renal function was studied preoperatively and during the first postoperative hour with a standard clearance technique. The patients were then randomly given furosemide, 1 mg/kg b.w., or mannitol, 0.5 g/kg b.w. Renal function was further investigated during the following 6 h in periods of varying duration. The injection of furosemide caused an initial increase of renal plasma flow (RPF), while glomerular filtration rate (GFR) decreased. Striking increases of urine flow, fractional sodium, fractional chloride and fractional osmolal excretion were found. These increases reached maximum levels during the second 20-min clearance period after the injection. Fractional free water reabsorption decreased and during the first 20-min clearance period it changed into free water clearance. These changes had reached or nearly reached the preoperative control levels after 6 h. The infusion of mannitol caused an initial rise in RPF, while GFR remained stable. Increases were found in urine flow, fractional sodium, fractional chloride, fractional osmolal excretions and fractional free water reabsorption. The changes reached maximum levels during the first 20-min control period and then gradually returned to the preoperative control levels. Mannitol did not impair GFR and had a milder effect on renal function than furosemide. The losses of sodium and water were much smaller in the mannitol group than in the furosemide group. It is therefore concluded that mannitol should be used as the diuretic of choice in the treatment of postoperative oliguria in patients without known cardiovascular disease associated with increased preload and/or left ventricular insufficiency.

Original languageEnglish (US)
Pages (from-to)173-183
Number of pages11
JournalActa Anaesthesiologica Scandinavica
Volume22
Issue number2
StatePublished - 1978
Externally publishedYes

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Furosemide
Mannitol
Postoperative Period
Kidney
Glomerular Filtration Rate
Renal Plasma Flow
Water
Sodium Chloride
Urine
Oliguria
Injections
Diuretics
Cardiovascular Diseases
Anesthesia
Sodium

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Acute effects of furosemide and mannitol on renal function in the early postoperative period. / Järnberg, Per-Olof; Eklund, J.; Granberg, P. O.

In: Acta Anaesthesiologica Scandinavica, Vol. 22, No. 2, 1978, p. 173-183.

Research output: Contribution to journalArticle

Järnberg, Per-Olof ; Eklund, J. ; Granberg, P. O. / Acute effects of furosemide and mannitol on renal function in the early postoperative period. In: Acta Anaesthesiologica Scandinavica. 1978 ; Vol. 22, No. 2. pp. 173-183.
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