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Atrial natriuretic peptide infusion and nitric oxide inhalation in patients with acute respiratory distress syndrome
| Content Provider | Semantic Scholar |
|---|---|
| Author | Hoeven, Johannes G. Van Der Frölich, Marijke Meinders, Arend Edo |
| Copyright Year | 2001 |
| Abstract | AIM To study the effects of infusion of atrial natriuretic peptide (ANP) versus the inhalation of nitric oxide (NO) in patients with an early acute respiratory distress syndrome (ARDS). METHODS Ten patients with severe ARDS were studied in a crossover study design, within 72 hours after starting mechanical ventilation. We studied the effects of ANP infusion (10 ng/kg/min for 1 hour) and of inhalation of NO (20 ppm for 1 hour) on hemodynamic and respiratory patient parameters, as well as the effects on plasma levels of ANP, guanosine 3',5'-cyclic monophosphate, nitrate and endothelin-1. RESULTS Despite an approximate 50% increase in mixed venous ANP plasma concentration (from 86 +/- 21 to 123 +/- 33 ng/l, P < 0.05) during ANP infusion, there were no changes in mean pulmonary artery pressure, pulmonary vascular resistance index, extravascular lung water index, or in pulmonary gas exchange. NO inhalation, in contrast, lowered mean pulmonary artery pressure (from 26 +/- 1.9 to 23.9 +/- 1.7 mmHg, P < 0.01), pulmonary vascular resistance index (from 314 +/- 37 to 273 +/- 32 dynes/cm5/m2, P < 0.05) and central venous pressure (from 8.2 +/- 1.2 to 7.3 +/- 1.1 mmHg, P < 0.02). Furthermore, NO inhalation improved pulmonary gas exchange, reflected by a decrease in alveolar-arterial oxygen gradient (from 41.9 +/- 3.9 to 40.4 +/- 3.6 kPa, P < 0.05), a small increase in oxygenation (PaO2/FiO2 from 17.7 +/- 1.4 to 19.7 +/- 1.1 kPa, P = 0.07) and a small decrease in venous admixture (Qs/Qt from 35.7 +/- 2.0 to 32.8 +/- 2.7%, P = 0.11). CONCLUSION This study shows that, in contrast to NO inhalation, infusion of ANP neither improves oxygenation nor attenuates pulmonary hypertension or pulmonary edema in patients with severe ARDS. |
| Starting Page | 151 |
| Ending Page | 157 |
| Page Count | 7 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 11353932v1 |
| Volume Number | 5 |
| Journal | Critical care |
| Alternate Webpage(s) | http://ftp.ncbi.nlm.nih.gov/pub/pmc/ec/70/CC-5-3-151.PMC31579.pdf |
| Alternate Webpage(s) | http://download-redirector.springer.com/redirect?contentType=pdf&ddsId=art:10.1186/cc1015&originUrl=http://ccforum.biomedcentral.com/article/10.1186/cc1015 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Alveolar ventilation function Burnett Schwartz Berberian syndrome Cell Respiration Central venous pressure Endothelin-1 Extravascular Lung Water Gradient Guanosine Tetraphosphate Heart Atrium Hypertensive disease Idiopathic Pulmonary Fibrosis Inspiration function Kilopascal Mechanical ventilation Nanogram per Kilogram Nanogram per Liter Nesiritide Nitrates Nitric Oxide Partial Pressure Arterial Oxygen to Fraction Inspired Oxygen Ratio Measurement Patients Pulmonary Edema Pulmonary Gas Exchange Pulmonary Hypertension Pulmonary Valve Insufficiency Respiratory Distress Syndrome, Adult Respiratory Insufficiency Structure of parenchyma of lung Venous Blood Pressure Venous Thromboembolism torr |
| Content Type | Text |
| Resource Type | Article |
