SERUM CREATININE LEVELS DURING CARDIAC-SURGERY - ABSENCE OF EFFECT BYAMINOGLYCOSIDES

The literature indicates that the relative nephrotoxicities of the thr ee drugs used in this investigation are gentamicin > tobramycin greate r-than-or-equal-to netilmicin. Serum creatinine levels over time were used in an attempt to elucidate the situation. They varied widely in a ll three groups and in controls in theatre. No definite trend was show n. Measurements performed for the ICU period showed continued variatio n. Fluctuations were so great during the perioperative period that the levels were analysed in terms of 44 mumol/litre difference between ad mission and discharge, ignoring changes between these times. It is now clear that the operative procedure itself is associated with fluctuat ing serum creatinine levels. The use of these aminoglycosides does not measureably affect the situation adversely over the short period of t reatment. The use of nomograms, based on creatinine levels, to set ami noglycoside doses during the perioperative period may therefore be mis leading, because of the wide fluctuations shown.