High frequency jet ventilation is associated with increased levels of plasma α-atrial natriuretic peptide — a preliminary study

Abstract

P Pu ur rp po os se e: : To determine if high frequency jet ventilation (HFJV) influences the secretion of α-atrial natriuretic peptide (α-ANP).M Me et th ho od ds s: : Sixteen patients undergoing otolaryngeal surgery were studied. Nine patients were subjected to intermittent positive pressure ventilation (IPPV), and seven patients underwent HFJV. Blood samples were drawn for the measurement of plasma α-ANP levels and blood gases before anesthesia, and at 30-min after starting either type of ventilation. The study was started at 2:00 p.m., and was completed before surgery. The plasma concentration of α-ANP was assayed by radioimmunoassay.R Re es su ul lt ts s: : There were no significant differences in mean arterial pressure, heart rate, oxygenation index and PaCO 2 between the two groups. IPPV was not associated with any changes in plasma -ANP levels, whereas HFJV was associated with significantly increased plasma α-ANP levels (from 60.0 ± 5.7 pg·mL -1 before anesthesia to 112.0 ± 11.6 pg·mL -1 after ventilation, P < 0.01). The urine output of the HFJV patients was significantly greater than that of the IPPV patients (P < 0.05).C Co on nc cl lu us si io on n: : These preliminary results suggest that HFJV is associated with a significant increase in plasma ANP and in urine output in anesthetized patients. TRIAL natriuretic peptide (ANP) is a cardiac hormone that has potent diuretic, natriuretic and vasorelaxant activities, and plays a role in regulating blood pressure and fluid homeostasis. 1 Recent studies have suggested that a decrease in the plasma ANP concentration contributes to the renal effects of controlled mechanical ventilation (CMV) with positive end-expiratory pressure (PEEP). [2][3][4] On the other hand, the authors have observed that polyuria has often been observed during high frequency jet ventilation (HFJV). However, little is known about the effects of HFJV on the plasma concentration of ANP and renal function. This study was designed to investigate the changes in the plasma ANP concentration during HFJV in comparison to IPPV in a clinical setting. Objectif : Déterminer si la ventilation en jet à haute fréquence (VJHF) influence la sécrétion de peptides natriurétiques auriculaires-α (PNA-α). Méthode