Simultaneous PAH, inulin and renografin-I-131 renal clearance determinations and a method for calculating renografin clearance from renograms in patients.
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Aminohippuric Acids↗
Biomedical subjects
W H Boyce
Publications and source records attributed to W H Boyce.
Changing renal blood flow following sodium nitroprusside in patients undergoing nephrolithotomy.
During nephrolithotomy in 23 adult patients under sodium thiopental-N2O-O2-fentanyl anesthesia, renal blood flow to one kidney was studied. Muscle relaxation was obtained with pancuronium, and renal blood flow (RBF) was measured with an electromagnetic flow probe. Percutaneous arterial pressures were also recorded. Administration of sodium nitroprusside caused a decrease in RBF in all patients when mean arterial pressure (MAP) was reduced approximately 44 percent below baseline. Patients whose initial RBF was below 300 ml/min showed greater falls in RBF with hypotension. Changes in renal vascular resistance (MAP/RBF) was found to be markedly higher in the "low-flow" group. As expected, the low-flow group started with a higher renal vascular resistance. From these observations, it is felt that more concern should be exercised when planning deliberate hypotension with nitroprusside, especially in patients with decreased renal function.
Adult↗
Hypertension and decreased renal blood flow following methylene blue injection.
Renal blood flow (RBF) and arterial blood pressure (BP) were monitored in 12 patients undergoing nephrolithotomy in the lateral flexed position. All patients were preoxygenated and were anesthetized with sodium thiopental, N2O, O2, and fentanyl. Maintenance relaxation was obtained with pancuronium bromide. Arterial pressure was monitored by percutaneous arterial catheter. Following exposure of the kidney and renal pedicle, an electromagnetic flow probe was attached to the renal artery and baseline flows recorded. Following baseline measurements, 20 ml of 1 percent methylene blue was given intravenously. All patients studied showed an immediate rise in BP, and 11/12 showed a simultaneous decrease in RBF. The average fall in RBF was 35 percent at one minute. Both parameters returned to normal values on the average in 177 seconds. The decreased RBF appeared to be part of a generalized vasoconstrition caused either by sympathetic reflexes or by the direct action of methylene blue.
Adult↗