Interactions between hemodynamic and hormonal modifications during PEEP-induced antidiuresis and antinatriuresis.
Chest
; 107(4): 1095-100, 1995 Apr.
Article
em En
| MEDLINE
| ID: mdl-7705122
ABSTRACT
The interactions between hemodynamic and hormonal modifications during antidiuresis and antinatriuresis induced by positive end-expiratory pressure (PEEP) were studied in six patients under 15 cm H2O PEEP before PEEP and after the addition of lower body positive pressure (LBPP) to PEEP (PEEP+LBPP). We measured or calculated the following cardiac index, systemic arterial, right atrial, pulmonary arterial, and pulmonary artery occlusive pressures; indexed renal blood flow (iodohippurate 131 sodium clearance); total blood volume (chromium 51 radiolabeled RBCs); glomerular filtration rate; urinary output; fractional excretion of sodium (FE Na+); plasma concentrations of antidiuretic hormone (ADH), plasma renin activity (PRA), norepinephrine and epinephrine; urinary concentration of PGE2 (PGE2u). Although LBPP application corrected PEEP deleterious effects on systemic and renal hemodynamics, sustained fall in Vu and in FE Na+ were observed. Antidiuresis was not due to ADH release. Sympathetic activation and high PRA appeared the main determinants of renal function alterations in PEEP ventilation.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Respiração com Pressão Positiva
/
Diurese
/
Hemodinâmica
/
Rim
/
Natriurese
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Chest
Ano de publicação:
1995
Tipo de documento:
Article
País de afiliação:
França