Dosagem do fator natriurético atrial em pacientes pediátricos submetidos à ventilação pulmonar mecânica

Costa, Kassandra Silva Falcão; Carvalho, Werther Brunow de; Kopelman, Benjamin Israel; Didio, R.

doi:10.1590/s0104-42302000000400030

Cited by 3 publications

(2 citation statements)

References 6 publications

(8 reference statements)

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“…The second possibility would be that our patients were submitted to mechanical ventilation whose level of positive end-expiratory pressure led to higher transpulmonary cardiac pressure, compromising atrial distension and, thereafter, the release of ANP 20 . Such mechanism would be applied to BNP for the impairment of the cardiac ventricles distension 21 .…”

Section: Discussionmentioning

confidence: 99%

Hyponatremia and brain injury: absence of alterations of serum brain natriuretic peptide and vasopressin

Costa

Nakamura

Cruz

et al. 2009

Arq. Neuro-Psiquiatr.

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-Objective: To study any possible relation between hyponatremia following brain injury and the presence of cerebral salt-wasting syndrome (CSWS) or the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and if vasopressin, brain natriuretic peptide (BNP) and aldosterone have a role in its mechanism. Method: Patients with brain injury admitted to the intensive care unit were included and had their BNP, aldosterone and vasopressin levels dosed on day 7. Results: Twenty six adult patients were included in the study. Nine (34.6%) had hyponatremia and presented with a negative water balance and higher values of urinary sodium, serum potassium and diuresis than patients with normonatremia. The serum levels of BNP, aldosterone, and vasopressin were normal and no relation was observed between plasma sodium and BNP, aldosterone or vasopressin. Conclusion: The most likely cause of hyponatremia was CSWS and there was no correlation between BNP, aldosterone and vasopressin with serum sodium level.Key WorDS: hyponatremia, brain injury, natriuretic peptide, aldosterone, vasopressin.Hiponatremia e traumatismo cranioencefálico: ausência de alteração sanguínea do peptídeo natriurético cerebral e hormônio antidiurético resumo -Objetivo: estudar a possível relação entre a hiponatremia seguindo traumatismo cranioencefálico e a presença da síndrome cerebral perdedora de sal (SCPS) ou a síndrome da secreção inapropriada do hormônio antidiurético (SSIHAD), e se a vasopressina, peptídeo natriurético cerebral (BNP) e aldosterona têm um papel nesse mecanismo. Método: Foram incluídos pacientes com traumatismo cranioencefálico admitidos na unidade de terapia intensiva e foram dosados no sétimo dia seguindo o trauma, BNP, aldosterona e vasopressina. Resultados: Vinte e seis pacientes foram incluídos no estudo. Nove (34,6%) tiveram hiponatremia e apresentaram um balanço hídrico mais negativo e altos valores de sódio urinário, potássio sérico e diurese quando comparados com o grupo que apresentou normonatremia. os níveis séricos de BNP, aldosterona e vasopressina foram normais e não foi observada relação entre o sódio sérico e BNP, aldosterona e vasopressina. Conclusão: A causa mais provável da hiponatremia foi a SCPS e não houve correlação entre BNP, aldosterona e vasopressina com o nível sérico de sódio.

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Section: Discussionmentioning

confidence: 99%

Hyponatremia and brain injury: absence of alterations of serum brain natriuretic peptide and vasopressin

Costa

Nakamura

Cruz

et al. 2009

Arq. Neuro-Psiquiatr.

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“…Patients with AVB under MV tend to develop water retention caused by the stimulation of the renin-angiotensin-aldosterone system via the increased secretion of antidiuretic hormone and natriuretic peptide. ( 12 - 14 ) These mechanisms induce sodium retention, with a consequent reduction in urine output. In addition, the use of sedatives and analgesics favors the development of peripheral vasoplegia, with a consequent reduction in the venous return and worsening of peripheral edema.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and progression of children with acute viral bronchiolitis subjected to mechanical ventilation

Ferlini¹,

Pinheiro²,

Andreolio³

et al. 2016

Revista Brasileira De Terapia Intensiva

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ObjectiveTo analyze the characteristics of children with acute viral bronchiolitis subjected to mechanical ventilation for three consecutive years and to correlate their progression with mechanical ventilation parameters and fluid balance.MethodsLongitudinal study of a series of infants (< one year old) subjected to mechanical ventilation for acute viral bronchitis from January 2012 to September 2014 in the pediatric intensive care unit. The children's clinical records were reviewed, and their anthropometric data, mechanical ventilation parameters, fluid balance, clinical progression, and major complications were recorded.ResultsSixty-six infants (3.0 ± 2.0 months old and with an average weight of 4.7 ± 1.4kg) were included, of whom 62% were boys; a virus was identified in 86%. The average duration of mechanical ventilation was 6.5 ± 2.9 days, and the average length of stay in the pediatric intensive care unit was 9.1 ± 3.5 days; the mortality rate was 1.5% (1/66). The peak inspiratory pressure remained at 30cmH2O during the first four days of mechanical ventilation and then decreased before extubation (25 cmH2O; p < 0.05). Pneumothorax occurred in 10% of the sample and extubation failure in 9%, which was due to upper airway obstruction in half of the cases. The cumulative fluid balance on mechanical ventilation day four was 402 ± 254mL, which corresponds to an increase of 9.0 ± 5.9% in body weight. Thirty-seven patients (56%) exhibited a weight gain of 10% or more, which was not significantly associated with the ventilation parameters on mechanical ventilation day four, extubation failure, duration of mechanical ventilation or length of stay in the pediatric intensive care unit.ConclusionThe rate of mechanical ventilation for acute viral bronchiolitis remains constant, being associated with low mortality, few adverse effects, and positive cumulative fluid balance during the first days. Better fluid control might reduce the duration of mechanical ventilation.

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Mechanisms Underlying Combined Acute Renal Failure and Acute Lung Injury in the Intensive Care Unit

Chien

King

Rabb

2004

Contributions to Nephrology

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Dosagem do fator natriurético atrial em pacientes pediátricos submetidos à ventilação pulmonar mecânica

Cited by 3 publications

References 6 publications

Hyponatremia and brain injury: absence of alterations of serum brain natriuretic peptide and vasopressin

Hyponatremia and brain injury: absence of alterations of serum brain natriuretic peptide and vasopressin

Characteristics and progression of children with acute viral bronchiolitis subjected to mechanical ventilation

Mechanisms Underlying Combined Acute Renal Failure and Acute Lung Injury in the Intensive Care Unit

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