Volemic status influences the response of plasma atrial natriuretic factor to positive airway pressure.

Details

Serval ID
serval:BIB_32B1B8814E2E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Volemic status influences the response of plasma atrial natriuretic factor to positive airway pressure.
Journal
Chest
Author(s)
Beuret P., Feihl F., Nussberger J., Brunner H.R., Perret C.
ISSN
0012-3692
Publication state
Published
Issued date
1996
Peer-reviewed
Oui
Volume
109
Number
5
Pages
1313-9
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
STUDY OBJECTIVE; To evaluate interactive effects of volemic status and positive end-expiratory pressure (PEEP) on the plasma levels of atrial natriuretic factor (ANF) in assist-controlled mechanical ventilation (MV). DESIGN: Three successive protocols applied in randomized order to each participant. SETTING: Clinical investigation laboratory. PARTICIPANTS: Twenty-one young, healthy adults. INTERVENTIONS: The three protocols were as follows: (1) MV+PEEP, normovolemia; (2) MV+PEEP, hypervolemia; and (3) spontaneous breathing (SB), hypervolemia. In protocols 1 and 2, a preliminary period of SB lasting 2 h was followed by MV alone (0.5 h), MV+20 cm H2O PEEP (1 h), and a recovery period of SB (1.5 h). Hypervolemia was induced by the continuous i.v. infusion of 3 L of 0.9% NaCl in 5 h (protocols 2 and 3). MEASUREMENTS AND RESULTS: Heart rate, BP, and the plasma levels of immunoreactive ANF and catecholamines were measured serially. During hypervolemia, ANF significantly decreased when PEEP was added to MV (protocol 2: from 31.1 +/- 2.7 to 20.7 +/- 1.5 fmol/mL; p < 0.01). This did not occur in normovolemia (protocol 1: from 20.0 +/- to 16.7 +/- 1.2 fmol/mL; p = NS). The different effects of MV+PEEP in normovolemia and hypervolemia were not related to differences in circulating catecholamine levels. CONCLUSIONS: These results demonstrate for the first time (to our knowledge) that volemic status modulates the response of plasma ANF to PEEP in humans. The role of ANF in the water and salt retention induced by MV with PEEP might be limited to hypervolemic conditions.
Keywords
Adult, Atrial Natriuretic Factor, Blood Pressure, Blood Volume, Catecholamines, Female, Heart Rate, Humans, Male, Positive-Pressure Respiration, Reference Values
Pubmed
Web of science
Create date
05/03/2008 17:40
Last modification date
20/08/2019 14:18
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