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Title: Diuretic Agent and Normal Saline Infusion Technique for Ultrasound-Guided Percutaneous Nephrostomies in Nondilated Pelvicaliceal Systems

Abstract

Percutaneous nephrostomy (PCN) in a nondilated pelvicaliceal system is technically challenging. We describe an effective method to achieve transient dilatation of the pelvicaliceal system via induction of diuresis using infusion of a diuretic agent in normal saline, therefore allowing easier access to the pelvicaliceal system. Under real-time ultrasound guidance, the technique had been tested in 22 nephrostomies with nondilated system (a total of 20 patients with 2 patients having bilateral nephrostomies) during a 5-year period. Patients were given 40 mg of furosemide in 250 ml of normal saline solution intravenously by rapid infusion. As soon as maximum calyceal dilatation of more than 5 mm was observed, which is usually 15 min later after the end of rapid infusion, patients were positioned obliquely, and PCN procedure under ultrasound guidance was performed. The procedure was successful in 19 of the nephrostomies in 17 patients with a success rate of 86.36 % per procedure and 85 % per patient in nondilated pelvicaliceal systems. No major nephrostomy-, drug-, or technique-related complications were encountered. The technique failed to work in three patients due to the presence of double J catheters and preexisting calyceal perforation which avoided transient dilation of the pelvicaliceal system with diuresis. Diureticmore » infusion in saline is a feasible and effective method for PCN in nondilated pelvicaliceal systems.« less

Authors:
; ;  [1]; ;  [2]
  1. Ankara University, Department of Urology, School of Medicine (Turkey)
  2. Ankara University, Department of Radiology, School of Medicine (Turkey)
Publication Date:
OSTI Identifier:
22156368
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 36; Journal Issue: 2; Other Information: Copyright (c) 2013 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Article Copyright (c) 2012 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; DIURETICS; INFUSION; MAGNESIUM 40; PATIENTS; TRANSIENTS

Citation Formats

Yagci, Cemil, Ustuner, Evren, Atman, Ebru Dusunceli, E-mail: ebrumd2001@yahoo.com, Baltaci, Sumer, Uzun, Caglar, and Akyar, Serdar. Diuretic Agent and Normal Saline Infusion Technique for Ultrasound-Guided Percutaneous Nephrostomies in Nondilated Pelvicaliceal Systems. United States: N. p., 2013. Web. doi:10.1007/S00270-012-0461-6.
Yagci, Cemil, Ustuner, Evren, Atman, Ebru Dusunceli, E-mail: ebrumd2001@yahoo.com, Baltaci, Sumer, Uzun, Caglar, & Akyar, Serdar. Diuretic Agent and Normal Saline Infusion Technique for Ultrasound-Guided Percutaneous Nephrostomies in Nondilated Pelvicaliceal Systems. United States. https://doi.org/10.1007/S00270-012-0461-6
Yagci, Cemil, Ustuner, Evren, Atman, Ebru Dusunceli, E-mail: ebrumd2001@yahoo.com, Baltaci, Sumer, Uzun, Caglar, and Akyar, Serdar. 2013. "Diuretic Agent and Normal Saline Infusion Technique for Ultrasound-Guided Percutaneous Nephrostomies in Nondilated Pelvicaliceal Systems". United States. https://doi.org/10.1007/S00270-012-0461-6.
@article{osti_22156368,
title = {Diuretic Agent and Normal Saline Infusion Technique for Ultrasound-Guided Percutaneous Nephrostomies in Nondilated Pelvicaliceal Systems},
author = {Yagci, Cemil and Ustuner, Evren and Atman, Ebru Dusunceli, E-mail: ebrumd2001@yahoo.com and Baltaci, Sumer and Uzun, Caglar and Akyar, Serdar},
abstractNote = {Percutaneous nephrostomy (PCN) in a nondilated pelvicaliceal system is technically challenging. We describe an effective method to achieve transient dilatation of the pelvicaliceal system via induction of diuresis using infusion of a diuretic agent in normal saline, therefore allowing easier access to the pelvicaliceal system. Under real-time ultrasound guidance, the technique had been tested in 22 nephrostomies with nondilated system (a total of 20 patients with 2 patients having bilateral nephrostomies) during a 5-year period. Patients were given 40 mg of furosemide in 250 ml of normal saline solution intravenously by rapid infusion. As soon as maximum calyceal dilatation of more than 5 mm was observed, which is usually 15 min later after the end of rapid infusion, patients were positioned obliquely, and PCN procedure under ultrasound guidance was performed. The procedure was successful in 19 of the nephrostomies in 17 patients with a success rate of 86.36 % per procedure and 85 % per patient in nondilated pelvicaliceal systems. No major nephrostomy-, drug-, or technique-related complications were encountered. The technique failed to work in three patients due to the presence of double J catheters and preexisting calyceal perforation which avoided transient dilation of the pelvicaliceal system with diuresis. Diuretic infusion in saline is a feasible and effective method for PCN in nondilated pelvicaliceal systems.},
doi = {10.1007/S00270-012-0461-6},
url = {https://www.osti.gov/biblio/22156368}, journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 2,
volume = 36,
place = {United States},
year = {Mon Apr 15 00:00:00 EDT 2013},
month = {Mon Apr 15 00:00:00 EDT 2013}
}