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Effectiveness of human atrial natriuretic peptide supplementation in pulmonary edema patients using the pulse contour cardiac output system.
Effectiveness of human atrial natriuretic peptide supplementation in pulmonary edema patients using the pulse contour cardiac output system.
- Source :
-
Yonsei medical journal [Yonsei Med J] 2010 May; Vol. 51 (3), pp. 354-9. - Publication Year :
- 2010
-
Abstract
- Purpose: Atrial natriuretic peptide (ANP) has a variety of pharmacologic effects, including natriuresis, diuresis, vasodilatation, and suppression of the reninangiotensin system. A recent study showed that ANP infusion improved hypoxemia and pulmonary hypertension in a lung injury model. On the other hand, the pulse contour cardiac output (PiCCO(TM)) system (Pulsion Medical Systems, Munich, Germany) allows monitoring of the intravascular volume status and may be used to guide volume therapy in severe sepsis and critically ill patients.<br />Materials and Methods: We treated 10 pulmonary edema patients without heart disease with human ANP (HANP). The patients were divided into two groups: a group with normal Intrathoracic Blood Volume (ITBV) (900-1100 mL/m(2)) (n = 6), and a group with abnormal ITBV (n = 4), as measured by the PiCCO(TM) device; the extravascular lung water (EVLW) and pulmonary vascular permeability index (PVPI) in the two groups were compared.<br />Results: The average patient age was 63.9 +/- 14.4 years. The normal ITBV group showed significant improvement of the EVLW (before, 16.7 +/- 2.7 mL/kg; after, 10.5 +/- 3.6 mL/kg; p = 0.0020) and PVPI (before, 3.2 +/- 0.3; after, 2.1 +/- 0.7; p = 0.0214) after the treatment. The abnormal ITBV group showed no significant improvement of either the EVLW (before, 16.3 +/- 8.9 mL/kg; after, 18.8 +/- 9.6 mL/kg; p = 0.8387) or PVPI (before, 2.3 +/- 0.8; after, 2.7 +/- 1.3; p = 0.2782) after the treatment. In both groups, the EVLW and PVPI were strongly correlated with the chest X-ray findings.<br />Conclusion: We conclude that HANP supplementation may improve the EVLW and PVPI in pulmonary edema patients without heart disease with a normal ITBV. The PiCCO(TM) system seems to be a useful device for the management of pulmonary edema.
- Subjects :
- Aged
Atrial Natriuretic Factor administration & dosage
Female
Humans
Injections, Intravenous
Male
Middle Aged
Atrial Natriuretic Factor therapeutic use
Cardiac Output drug effects
Cardiac Output physiology
Monitoring, Physiologic instrumentation
Pulmonary Edema drug therapy
Pulmonary Edema physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1976-2437
- Volume :
- 51
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Yonsei medical journal
- Publication Type :
- Academic Journal
- Accession number :
- 20376887
- Full Text :
- https://doi.org/10.3349/ymj.2010.51.3.354