The Effect Of The Duration Of Aortic Cross-clamping And Uiinastatin On Serum Creatinine, Urea Nitrogen During Abdominal Aortic Aneurysm Operations

Objective: To determine the effect of the duration of aortic cross-clamping during elective infrarenal abdominal aortic aneurysm (AAA) repairoperations on postoperative renal function and to determine the beneficialeffects of Ulinastatin on renal function of abdominal aortic aneurysm patients.Method:58AAA patients, had been excluded patients whose preope-rative serum creatinine levels≥133μmol/L to avoid any possible bias of theresults.The patients are divided into2groups according to the duration ofaortic cross-clamping (<50min group [N=30]; and≥50min group [N=13]) andother2groups according to whether use Ulinastatin before operation(Ulinastatin group [N=15]; and control group: Ulinastatin non-use [N=13]).theyall accepted epidural block combined with general anesthesia andIntraoperative control of low temperature, low pressure. According to thechanges of hemodynamic parameters and blood gas analysis to determine thetype, quantity and the speed of infusion. Whether give Postoperative analgesiais according to the conditions of the patients to avoid the fluctuation of bloodpressure caused by the pain. The duration of aortic cross-clamping, the amountof blood loss, as well as the number of intra-operative fresh frozen plasma andwhole blood transfusions, CVP, Urine volume,pre-operative creatinine andBUN, post-operative creatinine and BUN, Heart rate, pulse, temperature,oxygen saturation, blood gas, electrolyte, blood transfusion and infusionvolume and length of postoperative hospital stay were recorded in all cases.Analyses were performed using the SPSS15.0for Windows (SPSS) andsignificance was defined as P<0.05.Result: In our study, each group did not vary significantly with respect to age, BMI, preoperative drug antiplatelet agents and antihypertensive agents use,smoking, the presence of hyperlipidemia, hypertension, diabetes mellitus andhistory of myocardial infarction. A prolonged (≥50min) duration of aorticcrossclamping was associated with an increase in post-operative serumcreatinin（P <0.05）;There was a significant association between pre-operativeUlinastatin use and better postoperative creatinine and BUN (P<0.05)valuescompared with Ulinastatin non-use.there were no significant differencesbetween the groups of the length of postoperative hospital stay.Conclusion:1. prolonged aortic cross-clamping time(≥50min) may be associated withpostoperative renal dysfunction in AAA operation.2. The peri-and postoperative Anesthesia management and administrationof hemodynamic stability should be carried out with caution to reduce the riskof postoperative vital organs dysfunction.3．Routine pre-operative Ulinastatin use may play a beneficial role inpostoperative renal function.