Document Detail


Effects of inverse ratio ventilation with PEEP on kidney function.
MedLine Citation:
PMID:  20446776     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Positive pressure ventilation influences hemodynamics and impairs renal function. The effects of inverse ratio ventilation (IRV) on hormonal response and renal function need to be investigated because this represents a highly invasive form of positive pressure ventilation. MATERIALS AND METHODS: Ten male patients were treated postoperatively for 60 min using five different ventilation modes. At the end of these periods, hemodynamics, urine production, fractional excretion of sodium (FESo), as well as the hormones, atrial natriuretic peptide (ANP), renin, angiotensin II, aldosterone, and antidiuretic hormone (ADH), were measured in plasma. RESULTS: Central venous pressure (CVP), ADH, and renin with a positive end-expiratory pressure (PEEP) of 15 cm H(2)O and an inspiration/expiration ratio (I:E) of 1:2 revealed significant increases from baseline, whereas CVP, renin, and FESo showed an increase with an PEEP of 15 cm H(2)O and an I:E ratio of 2:1. Urine production significantly decreased with an PEEP of 15 cm H(2)O and an I:E ratio of 2:1. CONCLUSIONS: IRV with PEEP induced clear effects on hemodynamics and hormonal responses (renin) as well as a decrease in urine production in patients with healthy renal and pulmonary systems after an operation. However, all parameters apart from FESo and renin remained within the normal range. Whether pathological values are also observed after longer periods of positive pressure ventilation shall be the subject of other studies.
Authors:
Marius G Dehne; Markus Meister; Rainer Röhrig; Christian Katzer; Valesko Mann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Renal failure     Volume:  32     ISSN:  1525-6049     ISO Abbreviation:  Ren Fail     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-08-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701128     Medline TA:  Ren Fail     Country:  England    
Other Details:
Languages:  eng     Pagination:  411-6     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Hospital Wittlich, 54516, Wittlich, Germany. mg.dehne@verbund-krankenhaus.de
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MeSH Terms
Descriptor/Qualifier:
Aldosterone / blood
Angiotensin II / blood
Blood Pressure
Hemodynamics
Humans
Kidney / physiopathology*
Kidney Function Tests
Male
Middle Aged
Positive-Pressure Respiration / adverse effects*,  methods
Postoperative Period
Sodium / urine
Urination
Vasopressins / blood
Chemical
Reg. No./Substance:
11000-17-2/Vasopressins; 11128-99-7/Angiotensin II; 52-39-1/Aldosterone; 7440-23-5/Sodium

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