ABSTRACT
Nine children aged 2 months to 13 (mean 6.6) years with renal hypertension were treated with captopril. The treatment lasted for 1.5 to 14 months. Maintenance doses ranged between 1 and 5 mg/kg/day. Good effect was achieved with captopril in children with normal renal function and in mild renal insufficiency. In patients with end-stage renal disease when dialysis failed to maintain normal body water captopril was ineffective.
Subject(s)
Captopril/therapeutic use , Hypertension, Renal/drug therapy , Captopril/adverse effects , Child , Child, Preschool , Clinical Trials as Topic , Female , Humans , Hypertension, Renal/complications , Infant , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/drug therapy , Leukopenia/chemically induced , MaleABSTRACT
The effect of heart surgery with and without cardiopulmonary by-pass on plasma levels of thyroxine (T4) and triiodothyronine (T3) was studied in 19 patients. It was found that even before the operation the plasma levels of T4 and of T3 were significantly lower in the by-pass group of patients in comparison with those without by-pass. This lower level of thyroid hormones could be explained by greater pre-operative stress. This presumption is supported by the finding of the greater pre-operative plasma concentrations of dopamine-beta-hydroxylase and growth hormone in patients of the by-pass group. While in patients not undergoing CPB a tendency to the decrease of plasma thyroid hormones was observed during the early postoperative phase, in patients of the by-pass group a small increase was observed. On the basis of the finding that thyroid hormones exercise powerful and specific effect on myocardial contractility, it is suggested that the low hormone level might have a role in the pathogenesis of postoperative low cardiac output syndrome.
Subject(s)
Cardiac Surgical Procedures , Thyroid Hormones/blood , Adult , Dopamine beta-Hydroxylase/blood , Female , Humans , Hydrocortisone/blood , Male , Postoperative PeriodABSTRACT
The circulating blood volume changes, plasma electrolytes, aldosterone as well as plasma-renin-activity (PRA) were studied in 14 patients following open-heart surgery with cardiopulmonary bypass (CPB) and in 14 patients following cardiac surgery without CPB. In both the groups a postoperative decrease of circulating blood volume was observed. This decrease occurred in spite of the positive fluid balance, and so a shift of fluid from vascular to extravascular compartment was likely. In the bypass group the plasma aldoserone level rose immediately after the operation and reached the peak on the first postoperative day. In the non-bypass group the aldosterone level started to fall after the operation, and reached the lowest level on the third postoperative day. The pattern of the postoperative PRA changes was almost identical with the aldosterone level changes in both the groups studied, which suggests that the activation of renin-angiotensin-aldosterone axis might be responsible for the observed plasma aldosterone changes.
