Continuous administration of recombinant human B-type natriuretic peptide can improve heart and renal function in patients after cardiopulmonary bypass surgery

Abstract

Background: Any cardiac surgery under cardiopulmonary bypass (CPB) will induce ischemia-reperfusion injury and systematic inflammatory response, which may lead to exacerbation. Conventional therapy strategy is to use inotropes, diuretics and vasodilator drugs, yet, the therapeutic effects of which need to be improved. Recombinant human B-type natriuretic peptide (rhBNP) has been shown to be efficacious in the treatment of acute decompensated heart failure and acute myocardial infarction. However, the effects of rhBNP on patients carried out CPB surgery is unknown. Methods: We retrospect 357 patients carried out CPB surgery between Jan 1st 2014 and Dec 31st 2015 of our department. And according the use of rhBNP, these patients were divided into two groups: rhBNP group and control group. Patients in rhBNP group were received continuous intravenous rhBNP (0.0075-0.01 μg/kg/min) in 6 hours after CPB surgery, for a period of 72 h. Hemodynamic parameters were measured immediately after CPB surgery, and then at 2, 4, 8, 12 and 24 h after surgery. Blood samples were obtained immediately after surgery and thereafter once a day at 6:00 AM within the first 3 days after surgery. The daily urine volume as well as the time of tracheal intubation, ICU stay and chest drainage were also recorded.

Effects of Recombinant Human Brain Natriuretic Peptide on Atrial Fibrillation After Coronary Artery Bypass Grafting

“…In this study, there were no deaths and no VT/VF in the rh-BNP group (0/52), and use rh-BNP did not increase the risk of death and malignant ventricular arrhythmia, which was consistent with previous studies. 28–30 Combining the clinical data before and after PSM in this study, we found that the patients in the rh-BNP group had worse conditions, such as lower ejection fraction, higher proportion of IABP implantation, and more inotropic support. Therefore, the use of rh-BNP in patients after CABG did not increase postoperative 30-day mortality, compared with other patients who had a fair condition.…”

Association between central haemodynamics and renal function in advanced heart failure: a nationwide study from Sweden

“…PAWP was the least influential of the four significant haemodynamic variables identified in our research and it is possible that its identification is a spurious finding due to overfitting of the statistical model 32 . However, a higher PAWP would be expected to result in higher circulating levels of natriuretic peptides, 33 thus increasing GFR through vasodilatory effects on glomerular afferent arterioles 34 . There are thus plausible pathophysiological explanations for the positive relationship between PAWP and GFR observed in our multivariable analysis.…”

“… 32 However, a higher PAWP would be expected to result in higher circulating levels of natriuretic peptides, 33 thus increasing GFR through vasodilatory effects on glomerular afferent arterioles. 34 There are thus plausible pathophysiological explanations for the positive relationship between PAWP and GFR observed in our multivariable analysis.…”

Efficacy of Statin Therapy Related to Baseline Renal Function in Patients with Rheumatic Heart Disease Undergoing Cardiac Surgery

“…In our study, most of the patients had a history of anticoagulant or antithrombosis therapy (48.5% patients took aspirin, 15.4% took clopidogrel, 9.6% took warfarin or other drugs, and patients with AF had injection of low molecular weight heparin). In several studies, drainage time was associated with a prolonged ICU stay and hospital stay because of complications of systemic inflammation, respiratory dysfunction, and infection [ 22 , 23 ]. Of the drainage removal, our study criteria are in accordance with those of Smulders et al [ 20 , 21 ].…”