Document Detail


Haemodynamic and endocrinological effects of noninvasive mechanical ventilation in respiratory failure.
MedLine Citation:
PMID:  9426094     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to investigate the haemodynamic and endocrinological effects of noninvasive positive pressure ventilation (NIPPV). Eleven patients with oedema and recent hypercapnic and hypoxaemic worsening of a chronic respiratory insufficiency were included. Echocardiography, cardiac radionuclide assessment, blood catecholamines, salt and water handling hormones were measured at admission and discharge (long study (LS)). To discriminate between the action of NIPPV and other treatments, measurements were performed on the fourth day, for 4 h without NIPPV and 4 h with NIPPV (short study (SS)). NIPPV entailed a correction of P(a,CO2) and an increase of P(a,O2) in LS and SS. Oedema disappeared. Body weight decreased (from 85+/-42 to 81+/-40 kg) during LS. Systolic and mean pulmonary arterial pressure decreased in LS and SS. Right ventricular ejection fraction increased in LS. Left ventricular ejection fraction did not change. Cardiac index was normal on admission and then decreased. Natriuretic peptides and catecholamines were increased on admission, whereas plasma renin activity, aldosterone and vasopressin were normal. We suggest that in these patients, oedema can occur independently of renin-angiotensin-aldosterone-vasopressin and with a normal cardiac output. Noninvasive positive pressure ventilation allowed a correction of blood gases, associated with the resolution of oedema, a decrease in pulmonary arterial pressures and an increase in right ventricular ejection fraction.
Authors:
J B Thorens; M Ritz; C Reynard; A Righetti; M Vallotton; H Favre; U Kyle; P Jolliet; J C Chevrolet
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The European respiratory journal     Volume:  10     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1998-02-05     Completed Date:  1998-02-05     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  2553-9     Citation Subset:  IM    
Affiliation:
Medical Intensive Care, Respiratory Division, Hôpital Cantonal Universitaire de Genève, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Atrial Natriuretic Factor / blood
Body Composition
Case-Control Studies
Edema / physiopathology
Female
Hemodynamics / physiology*
Hormones / blood*
Humans
Hypercapnia / physiopathology
Intermittent Positive-Pressure Ventilation / methods*
Male
Middle Aged
Natriuretic Peptide, Brain
Nerve Tissue Proteins / blood
Pulmonary Wedge Pressure / physiology
Respiratory Insufficiency / physiopathology*,  therapy*
Ventricular Function, Right / physiology
Water-Electrolyte Balance / physiology
Chemical
Reg. No./Substance:
0/Hormones; 0/Nerve Tissue Proteins; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor

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