Renal hemodynamics and antidiuretic hormone release associated with volume regulation

Abstract

Following the general reduction of extracellular fluid volume by hemorrhage, or the selective reduction of this volume in the thorax by positive pressure breathing, the volume regulating mechanism of the dog is implicated as part of the over-all compensatory mechanism to such stress situations, and appears to be dominant over any regulation via the osmoreceptors. Both these experimental procedures produce characteristic compensatory cardiovascular reactions, depressed renal function and highly significant increases in the circulating level of antidiuretic hormone. Following the isotonic expansion of the extracellular fluid volume with dextran, or selective expansion of the vascular capacity of the thorax by negative pressure breathing, the volume regulating mechanism appears to be subdominant to the control of body fluid volume via the osmoreceptors. In the case of an increase in extracellular fluid volume, reflex responses directed at volume regulation have no statistically significant action on renal hemodynamics, and any action on the release or inhibition of antidiuretic hormone could not be detected with certainty because of the limiting sensitivity of the bio-assay.

Does positive pressure ventilation increase arginine vasopressin in preterm neonates?

“…This is based on data from animal experiments17 18 and adult clinical studies 2. In animal experiments well animals are ventilated electively and may receive anaesthetic agents or sedation which could affect release of AVP.…”

Hemodynamics and renal function during low frequency positive pressure ventilation with extracorporeal CO2 removal

“…The possible role of ADH release has been suggested. Baratz and Ingraham [2] found an increase in ADH during CPPV. Baratz, Philbin and Patterson [3] also showed such an increase to be independent of atrial volume receptors.…”

“Essential” hypernatremia due to ineffective osmotic and intact volume regulation of vasopressin secretion

“…There is also evidence to sugggest that there are blood volume receptors in areas such as the left atrium, carotid artery, and aortic arch which mediate ADH secretion by reflex mechanisms (56)(57)(58)(59)(60)(61). Blood volume contraction stimulates (57,(62)(63)(64) and expansion inhibits (61,64,65) (45) or in hypotonic contraction (66,(69)(70)(71), vasopressin seems to be secreted in response to a rising plasma osmolality and falling volume (45,66,(69)(70)(71). The former observation water diuresis was also inhibited by orthostasis and likeis the basis of the usefulness of hypertonic saline in the differential diagnosis of polyuric states.…”