[Verse 1]
Renal blood flow, a quarter of cardiac output
Autoregulation holds the pressure, keeps the nephrons stout
Between sixty and one-sixty millimeters, the flow stays true
But drop below that window and the glomeruli are through
Anesthesia cuts the sympathetic tone, vasodilates the bed
Volatile agents trim the GFR, watch the creatinine instead
Surgery triggers neurohormonal storms, vasopressin floods the gate
Perioperative AKI — catch it early, don't wait
[Chorus]
Le rein, le foie, les glandes — tout est connecté
Cortisol, catecholamines, glucose dysrégulé
Buffer, clear, and filter through the operative haze
Les organes parlent ensemble — learn to read their ways
[Verse 2]
Hepatic blood flow splits between two tributaries, elegant design
Portal vein brings seventy-five percent, hepatic artery fills the line
When portal flow decreases, the artery dilates to compensate
That hepatic arterial buffer response — adenosine mediates the gate
Volatile agents slash total hepatic flow, halothane hits it hard
Propofol, ketamine, regionals — they guard the liver yard
Cytochrome P450 enzymes slow when perfusion falls away
Drug clearance stumbles, half-lives lengthen through the operative day
[Chorus]
Le rein, le foie, les glandes — tout est connecté
Cortisol, catecholamines, glucose dysrégulé
Buffer, clear, and filter through the operative haze
Les organes parlent ensemble — learn to read their ways
[Verse 3]
Surgical incision triggers the stress cascade, hypothalamus fires first
CRH to ACTH to cortisol — a hormonal thirst
Catecholamines spike the SVR, glucagon breaks the glycogen chain
Cytokines — IL-6, TNF-alpha — amplify the inflammatory refrain
Neuraxial anesthesia blunts this axis at the afferent arc
Epidural blocks the nociceptive signal, mutes the cortisol mark
Glucose climbs despite no carbohydrates — insulin resistance reigns
Tight glycemic control between one-forty and one-eighty still contains
[Bridge]
Adrenal insufficiency — the perioperative specter, quiet and sly
Exogenous steroids suppress the axis, stress doses or the patient will run dry
The thyroid slows under surgery, euthyroid sick syndrome fools the test
Free T3 drops, reverse T3 climbs — the pituitary still thinks it's best
Diabetes insipidus after pituitary surgery — ADH goes mute
Prolixity of fluid, sodium spikes — recognize this cardinal route
That rare word "prolixity" — an overflow, an excess that runs long
When AVP abandons post, the urine pours torrential and strong
[Chorus]
Le rein, le foie, les glandes — tout est connecté
Cortisol, catecholamines, glucose dysrégulé
Buffer, clear, and filter through the operative haze
Les organes parlent ensemble — learn to read their ways
[Outro]
Autoregulation, buffer response, the axis of cortisol and kin
Renal, hepatic, endocrine — three systems beneath the skin
Périopératoire — where physiology meets the blade
Know the mechanisms, read the signals, master the trade