Abstract
Purpose
To determine if high frequency jet ventilation (HFJV) influences the secretion of α-atrial natriuretic peptide (α-ANP).
Methods
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.
Results
There were no significant differences in mean arterial pressure, heart rate, oxygenation index and PaCO2 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).
Conclusion
These preliminary results suggest that HFJV is associated with a significant increase in plasma ANP and in urine output in anesthetized patients.
Résumé
Objectif
Déterminer si la ventilation en jet à haute fréquence (VJHF) influence la sécrétion de peptides natriurétiques auriculaires- α (PNA- α).
Méthode
L’étude a été réalisée auprès de 16 patients devant subir une intervention otolaryngologique. Neuf patients ont été soumis à une ventilation à pression positive intermittente (VPPI) et sept patients à une VJHF. Des échantillons sanguins ont été prélevés dans le but de mesurer les PNA- α plasmatiques et les gaz sanguins avant l’anesthésie et 30 min après le début de chacun des types de ventilation. L’étude a débuté à 14 h et s’est terminée avant l’opération. La concentration plasmatique de PNA- α a été déterminée par un dosage radio-immunologique.
Résultats
Aucune différence intergroupe significative n’a été relevée quant à la tension artérielle moyenne, la fréquence cardiaque, l’index d’oxygénation et la PaCO2. La VPPI n’a été associée à aucun changement plasmatique de PNA-α, tandis que la VJHF s’est accompagnée d’une augmentation significative des niveaux plasmatiques de PNA-α (de 60,0 ± 5,7 pg·mL−1 avant l’anesthésie à 112,0 ± 11,6 pg·mL−1 après la ventilation, P < 0,01). Le débit urinaire a été significativement plus élevé avec la VJHF qu’avec la VPPI (P < 0,05).
Conclusion
Ces résultats préliminaires permettent d’affirmer que la VJHF est associée à une hausse significative de PNA plasmatiques et du débit urinaire chez les patients anesthésiés.
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Nagatani, A., Niiya, S. & Sumikawa, K. High frequency jet ventilation is associated with increased levels of plasma α-atrial natriuretic peptide — a preliminary study. Can J Anesth 49, 517–521 (2002). https://doi.org/10.1007/BF03017934
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DOI: https://doi.org/10.1007/BF03017934