Document Detail

Atrial natriuretic factor may mediate the renal effects of PEEP ventilation.
MedLine Citation:
PMID:  2973759     Owner:  NLM     Status:  MEDLINE    
Mechanical ventilation with PEEP decreases urine output and urinary sodium excretion. Observed changes in cardiac output, renal blood flow, renin release, and antidiuretic hormone (ADH) secretion do not adequately explain the renal effects of PEEP. Altered release of atrial natriuretic factor (ANF), which is natriuretic and diuretic, may complete this explanation. The following hypothesis was tested: a PEEP-induced decrease in transmural right atrial pressure decreases ANF release, and this mechanism mediates subsequent alterations in renal function. Seven female mongrel dogs were anesthetized with halothane and their lungs ventilated mechanically for three consecutive 40 min periods of 0 PEEP, 10 cmH2O PEEP, and 0 PEEP. Addition of 10 cmH2O PEEP during mechanical ventilation decreased right atrial dimension and transmural right atrial pressure while intracavitary right atrial pressure was increased. Urine output was significantly decreased during PEEP, as were absolute and fractional excretion of sodium and osmolar clearance. PEEP ventilation resulted in a consistent and significant decline in plasma ANF concentration (82 +/- 11 to 62 +/- 11 pg/ml, P less than 0.05). Hemodynamic parameters, renal function, and ANF concentration returned to control values after cessation of PEEP. A second series of experiments in five dogs demonstrated a close temporal relationship between changes in atrial dimension or atrial transmural pressure, plasma ANF concentration, and urine output or sodium excretion. The results of this study demonstrate that PEEP-induced decreases in atrial distension resulted in decreased ANF release, which may mediate, in part, the antinatriuretic and antidiuretic effects of PEEP.
E D Kharasch; K T Yeo; M A Kenny; C W Buffington
Related Documents :
2656099 - Mediastinal, left, and right atrial pressure variations with different modes of mechani...
343629 - Positive end-expiratory pressure. immediate haemodynamic effects during artificial vent...
3899529 - Assisted ventilation in patients with preexisting cardiopulmonary disease. the effect o...
20072459 - Strengths, widths, and shapes of the oxygen lines near 13,100 cm(-1) (7620 a).
9817719 - Effect of different pressure levels on the dynamics of lung collapse and recruitment in...
14982649 - The use of high positive end-expiratory pressure for respiratory failure in abdominal c...
25027169 - Measurement of absolute copy number variation reveals association with essential hypert...
21901719 - Long-term effects of weight-reducing diets in hypertensive patients.
10744359 - Daily exercise attenuates the development of arterial blood pressure related cardiovasc...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Anesthesiology     Volume:  69     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  1988 Dec 
Date Detail:
Created Date:  1989-01-05     Completed Date:  1989-01-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  862-9     Citation Subset:  AIM; IM    
Department of Anesthesiology, University of Washington School of Medicine, Seattle 98195.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Atrial Function
Atrial Natriuretic Factor / blood,  secretion*
Blood Pressure*
Kidney / physiology*
Myocardial Contraction
Positive-Pressure Respiration*
Time Factors
Grant Support
Reg. No./Substance:
85637-73-6/Atrial Natriuretic Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Failure of a dengue 1 sub-unit vaccine to protect mice against a lethal dengue virus infection.
Next Document:  Hepatitis B vaccination programs for hospital workers: results of a statewide survey.