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Anesth Analg 1981; 60:641-645
© 1981 International Anesthesia Research Society
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Cardiovascular Responses and Changes in Plasma Cation Levels Associated with Infusion of Hyperosmolar Urea Solutions

Ronald M. Jones, MB, ChB, FFARCS*, Michael L. Nahrwold, MD{dagger}, A. Michael de Rosayro, MB, ChB, FFARCS{ddagger}, and Anne B. Hill, MB, ChB, FFARCS{ddagger}

* Instructor, Department of Anesthesiology, University of Michigan Medical Center. Present appointment: Consultant Anaesthetist, The University and City Hospitals, Nottingham. Present ad-dress: Department of Anaesthesia, The City Hospital, Hucknall Road, Nottingham NG5 IPB, Great Britain. {dagger} Associate Professor, Department of Anesthesiology, University of Michigan Medical Center. {ddagger} Assistant Professor, Department of Anesthesiology, University of Michigan Medical Center.

Abstract

In four patients, infusion of a hyperosmolar solution of urea to decrease brain volume was associated with hypotension and a decreasing of plasma levels of ionized calcium. This prompted a further study into the effects of intravenous hyperosmolar urea solutions on cardiovascular function and plasma levels of cations in the anesthetized dog. Using an infusion rate of 250 mg/kg/min, significant (p < 0.05) reductions in mean arterial pressure, systemic vascular resistance, hematocrit, and levels of plasma sodium and ionized calcium were found. These changes were associated with significant (p < 0.05) increases in cardiac output, right atrial pressure, arterial Po2 andPco2, and levels of plasma potassium. It is concluded that rapid infusions of hyperosmolar urea may have important effects on hemodynamic status and plasma cation concentrations.

Key Words: KIDNEY: diuretics, urea • ANESTHESIA: neurosurgical • SURGERY: neurologic






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1981 by the International Anesthesia Research Society.