Control of Water Balance in Infants with Bronchopulmonary Dysplasia: Role of Endogenous Vasopressin

Ta, Hazinski; Wa, Blalock; Engelhardt, Barbara

doi:10.1203/00006450-198801000-00019

Cited by 31 publications

(22 citation statements)

References 16 publications

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“…Kojima et al [2] demonstrated that AVP levels were higher in LBW infants, regardless of whether or not they had bronchopulmonary dysplasia (BPD), compared to term infants suggesting that AVP levels may be influenced by maturity at birth or birthweight. In contrast, Hazinski et al [1] did not find a relationship between AVP levels and gestational age in BPD infants nor was any correlation demonstrated between AVP levels and maturity in cord samples [14]. The infants in this study who went on to develop CLD were significantly more immature and tended to be lighter than the non-CLD infants.…”

Section: Discussioncontrasting

confidence: 49%

“…In such infants the elevated AVP levels were associated with hyponatraemia and fluid restriction [1,2]. Mechanical ventilation [3], pneumothorax [3,4] and infection [3], all risk factors for the development of CLD, are also associated with raised AVP levels.…”

Section: Introductionmentioning

confidence: 99%

“…Arginine vasopressin (AVP) levels have been demonstrated to be higher in infants with established [1] and early [2] chronic lung disease (CLD) than in infants of similar postconceptional age without ongoing respiratory problems. In such infants the elevated AVP levels were associated with hyponatraemia and fluid restriction [1,2].…”

Section: Introductionmentioning

confidence: 99%

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A Comparison of Arginine Vasopressin Levels and Fluid Balance in the Perinatal Period in Infants Who Did and Did Not Develop Chronic Oxygen Dependency

et al. 2000

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Arginine vasopressin (AVP) levels on days 1, 3 and 5 and fluid balance in the perinatal period were assessed in 60 infants, median gestational age 27 weeks (range 24–33). Fluid input and output, urine osmolality and episodes of hyponatraemia were recorded on a daily basis. Forty-one infants subsequently developed chronic lung disease (CLD), they were more immature, of lower birthweight and had higher AVP levels on days 3 and 5 (p < 0.05) than the rest of the cohort. Despite similar levels of fluid input, compared to the non-CLD infants, those who developed CLD had higher urine osmolalities on days 1, 5, 6 and 7 (p < 0.05), but there were not significant differences between the two groups regarding urine output or episodes of hyponatraemia. Logistic regression analysis revealed AVP levels on day 3 were significantly correlated with the duration of oxygen dependency independent of other factors. We conclude elevated AVP levels in the perinatal period are associated with CLD development, but our results suggest they have little functional significance.

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Section: Discussioncontrasting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

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A Comparison of Arginine Vasopressin Levels and Fluid Balance in the Perinatal Period in Infants Who Did and Did Not Develop Chronic Oxygen Dependency

et al. 2000

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“…Some of these symptoms are similar to those seen in patients with SIADH (4, 5). Recently, Hazinski et al (2) found that some infants with chronic BPD have elevated plasma AVP levels and they speculated the functional significance of these elevated values. However, all these articles are about water balance in the chronic stage of BPD.…”

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confidence: 99%

Changes in Vasopressin, Atrial Natriuretic Factor, and Water Homeostasis in the Early Stage of Bronchopulmonary Dysplasia

et al. 1990

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ABSTRACT. Arginine vasopressin (AVP), atrial natriuretic factor, and water balance were examined in the infants with or without bronchopulmonary dysplasia (BPD) during the first 4 wk of life. Fourteen premature infants, nine in the early stage of BPD secondary to respiratory distress syndrome (BPD infants) and five healthy low birthwt infants (LBW infants), were the subjects of this study. The water and sodium balance, renal function, and plasma AVP and atrial natriuretic factor concentrations were determined during the first 4 wk of life. Plasma AVP and atrial natriuretic factor levels of BPD infants at the 4th wk of life were higher than those of LBW infants at the corresponding age. Urine osmolality was higher and free water clearance was lower in BPD infants at the 4th wk of life when compared with each parameter in LBW infants, respectively. Pac02 of BPD infants at the 4th wk of life was more elevated than that of LBW infants. These results suggest that elevated plasma AVP level may be related with pulmonary abnormalities and that atrial natriuretic factor may hence compensate the water retention resulted from the functionally activated AVP in the early stage of BPD. (Pediatr Res 27: [260][261][262][263]1990) Abbreviations ANF, atrial natriuretic factor AVP, arginine vasopressin BPD, bronchopulmonary dysplasia Ccr, creatinine clearance CH20, free water clearance FENa, fractional excretion of sodium LBW, low birthwt RDS, respiratory distress syndrome SIADH, syndrome of inappropriate secretion of antidiuretic hormoneInfants with chronic BPD sometimes develop edema, oliguria, and hyponatremia (1-3). Some of these symptoms are similar to those seen in patients with SIADH (4, 5). Recently, Hazinski et al. (2) found that some infants with chronic BPD have elevated plasma AVP levels and they speculated the functional significance of these elevated values. However, all these articles are about water balance in the chronic stage of BPD. It has not been well established whether the changes of plasma AVP levels and water balance in the early stage of BPD are the same with those in chronic BPD.On the other hand, ANF, found and isolated from the heart, has potent natriuretic and diuretic activities ( 6 4 , even in the premature infants (9). Among a variety of physiological effects of ANF such as natriuresis, vasodilation, inhibition of aldosterone release (6, lo), it is suggested that ANF suppresses the AVP release (1 1, 12). We therefore investigated whether there are differences in plasma values of AVP, ANF, and water homeostasis during the 1st mo of life between infants in the early stage of BPD and healthy LBW infants. MATERIALS AND METHODSStudy protocol. Fourteen premature infants (eight boys and six girls), nine in the early stage of BPD secondary to RDS (BPD infants) and five LBW infants, were the subjects of this study. Informed consent was obtained from each patient's parents. Our definition of BPD was based on three criteria: requirement of positive pressure ventilation as treatment for RDS in the 1st wk of...

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“…It presumably results from the direct renal effects of furosemide, but it may also involve drug effects on the secretion of prolactin (25), vasopressin (26), or atrial natriuretic peptide. The mobilized water arises from the interstitial compartment and is not limited to pulmonary IW.…”

Section: Discussionmentioning

confidence: 99%

Effects of Furosemide on Body Water Compartments in Infants with Bronchopulmonary Dysplasia

O'donovan

Bell

1989

Pediatr Res

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ABSTRACT. We studied the effects of a single dose ofStudies in adults with pulmonary edema (5-7) have shown intravenous furosemide on the body water compartments variable effects of furosemide on plasma volume. Davidor et al.of nine infants with bronchopulmonary dysplasia. We (5) measured plasma vol in patients with refractory edema 2 h measured total body water, extracellular water, and plasma after an intravenous dose of furosemide. These patients had a volume using deuterium oxide, sodium bromide, and Evans mean decrease of 25% in plasma volume. Figueros and Weil(6) blue dye, respectively. From the results of these measure-found that the plasma volume of adults with acute cardiogenic ments, we calculated cell water, interstitial water, red cell pulmonary edema was lower than normal before therapy but volume, and total blood volume. We performed these meas-rose after treatment with furosemide, oxygen, and morphine.urements on the first day of the study and again 28 h later, Schuster et al. (7) measured blood volume in 2 1 patients with 4 h after an intravenous dose of furosemide (1 mglkg). All pulmonary edema who had either normal or decreased renal infants had a brisk diuresis in the first hour after the dose, function. The patients who had normal renal function, as indibut urine output was no greater during the 24-h period cated by a good diuresis, had no change in plasma volume 4 to after the dose than during the preceding 24-h period. Total 6 h after a single intravenous dose of furosemide. Patients who body water, extracellular water, and interstitial water were did not have a good diuresis had a rise in plasma volume. significantly decreased 4 h after furosemide. There was no There have been no similar studies in infants. Infants with change in plasma volume, red cell volume, or total blood BPD are often fluid restricted with the hope that this will reduce volume (Pediatr Res 26: 121-124, 1989) pulmonary edema. It would be of practical value to know whether furosemide causes a decrease in plasma volume in these Abbreviations infants, because hypovolumeemia might compromise organ perfusion and activate the compensatory mechanisms that stimulate BPD, bronchopulmonary dysplasia water and sodium retention. Our study was undertaken to assess TBW, total body water the effects of a single intravenous dose of furosemide on the IW, interstitial water plasma volume and other body water compartments of infants ECW, extracellular water with BPD. PV, plasma volume CBS, corrected bromide space Br, bromide MATERIALS AND METHODS

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Control of Water Balance in Infants with Bronchopulmonary Dysplasia: Role of Endogenous Vasopressin

Cited by 31 publications

References 16 publications

A Comparison of Arginine Vasopressin Levels and Fluid Balance in the Perinatal Period in Infants Who Did and Did Not Develop Chronic Oxygen Dependency

A Comparison of Arginine Vasopressin Levels and Fluid Balance in the Perinatal Period in Infants Who Did and Did Not Develop Chronic Oxygen Dependency

Changes in Vasopressin, Atrial Natriuretic Factor, and Water Homeostasis in the Early Stage of Bronchopulmonary Dysplasia

Effects of Furosemide on Body Water Compartments in Infants with Bronchopulmonary Dysplasia

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