| Fluid homeostasis in chronic obstructive lung disease. | |
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MedLine Citation:
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PMID: 14621105 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Chronic obstructive pulmonary disease (COPD) often leads to massive oedema and the development of what is usually called cor pulmonale. The mechanisms by which patients with COPD retain salt and water are not completely understood. Several abnormalities have been found including reduced renal blood flow with relatively preserved glomerular filtration rate and elevated levels of renin, aldosterone, arginine vasopressin and atrial natriuretic peptide. Generally, these abnormalities worsen with the severity of COPD and are most marked during the oedematous phases. Cardiac output is remarkably normal, suggesting that "cor pulmonale" is not primarily a cardiac disorder but rather a condition of volume overload due to activation of sodium-retaining mechanisms. The stimulus for this activation could be underfilling of the arterial system (reduced effective circulating volume) secondary to a fall in total peripheral vascular resistance. The latter is caused by hypercapnia-induced dilation of the precapillary sphincters. Apparently, the massive sodium retention by the kidney is not able to restore the circulating volume and a vicious cycle ensues ultimately leading to a clinical picture which resembles right-sided heart failure. Predictably, only blockade of the effects of carbon dioxide at the level of the precapillary sphincters would be able to halt this process. |
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Authors:
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P W de Leeuw; A Dees |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: The European respiratory journal. Supplement Volume: 46 ISSN: 0904-1850 ISO Abbreviation: Eur Respir J Suppl Publication Date: 2003 Nov |
Date Detail:
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Created Date: 2003-11-17 Completed Date: 2004-02-26 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8910681 Medline TA: Eur Respir J Suppl Country: Denmark |
Other Details:
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Languages: eng Pagination: 33s-40s Citation Subset: IM |
Affiliation:
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Dept of Medicine, University Hospital Maastricht, Maastricht, The Netherlands. p.deleeuw@intmed.unimaas.nl |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Edema
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etiology,
physiopathology Extracellular Fluid / physiology* Hemodynamics Homeostasis* Humans Kidney / physiopathology Neurotransmitter Agents / physiology Pulmonary Disease, Chronic Obstructive / complications, physiopathology* Pulmonary Heart Disease / etiology, physiopathology Renal Circulation Sodium / metabolism |
| Chemical | |
Reg. No./Substance:
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0/Neurotransmitter Agents; 7440-23-5/Sodium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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