atrial-natriuretic-factor and Pneumonia--Aspiration

To clarify how plasma atrial natriuretic peptide concentrations vary with the severity of acute lung injury. The influence of coexisting diseases which trigger acute lung injury was also examined.. Prospective study.. Intensive care unit of a university hospital.. Fifty patients who had standard risk factors for acute lung injury including sepsis syndrome, major surgery, prolonged hypotension, aspiration of gastric contents, and burns. Twenty-five of these patients had acute lung injury (group 3) caused by these disorders; the remaining 25 patients had risk factors only (group 2). Ten age-matched normal volunteers were selected as controls (group 1).. None.. Plasma atrial natriuretic peptide concentration was measured in these patients and compared with the severity of acute lung injury. In group 3, a significant increase in the mean plasma atrial natriuretic peptide concentration was observed (188 +/- 78 pg/mL, p < .01) compared with group 2 (54 +/- 28 pg/mL) and the age-matched control group (30 +/- 8 pg/mL). This increase was related to the onset of acute lung injury and returned to control concentrations after recovery. Plasma atrial natriuretic peptide concentrations in group 3 correlated highly with a lung injury score representing the severity of acute lung injury (r2 = .45, p < .01), but did not correlate with other cardiopulmonary variables.. The results suggest that severity of lung injury, but not other predisposing disorders, may be the key factor leading to the increase in plasma atrial natriuretic peptide concentrations observed in these patients.

Topics: Analysis of Variance; Atrial Natriuretic Factor; Burns; Comorbidity; Hemorrhage; Humans; Hypotension; Japan; Linear Models; Pneumonia, Aspiration; Prospective Studies; Respiratory Distress Syndrome; Risk Factors; Systemic Inflammatory Response Syndrome

Plasma concentrations of immunoreactive human atrial natriuretic peptide (human ANP) were sequentially determined in 12 infants with respiratory distress syndrome (RDS) or meconium aspiration syndrome (MAS) during various phases of diuresis to elucidate the role of human ANP in the occurrence of spontaneous diuresis in the newborn. Plasma immunoreactive ANP concentrations during the diuretic as well as the maximum diuretic phase were significantly (p less than 0.001) higher than during the prediuretic phase. A gradual decrease occurred during the post diuretic phase, returning to prediuretic values after one week of life. Significant natriuresis, increased glomerular filtration rate, mild hyponatremia, and decreased blood pressure were observed in the diuretic phase in all the cases studied. These results suggest that hypersecretion of human ANP may play an important part in initiating spontaneous diuresis in sick neonates.

Topics: Atrial Natriuretic Factor; Diuresis; Female; Humans; Infant, Newborn; Kidney; Male; Meconium; Pneumonia, Aspiration; Respiratory Distress Syndrome, Newborn; Syndrome; Urine