BACKGROUND: A cardiac hormone, alpha-human atrial natriuretic polypeptide (alpha-hANP), acts as a vasodilator and a diuretic by activating cyclic GMP formation. We studied the hemodynamic effects of continuous intravenous infusion of alpha-hANP on patients undergoing open-heart surgery. METHODS: A total of 15 patients, including 7 with CABG, 4 with AVR, 2 with CABG plus AVR, and 2 with AVR plus MVR were involved in the study. They underwent open-heart surgery in our institute between July 1996 and April 1997. The mean age of patients was 68 years, ranging from 63 to 77. A dosage of 0.05 microg/kg/min of alpha-hANP was administered to all patients on postoperative day 1. Hemodynamics and blood and urine samples were measured at the following times: 2 hours before continuous intravenous infusion of alpha-hANP, 0, 1, 2, 3, 6, 12 and 24 hours after continuous intravenous infusion. We concomitantly measured urine volume and the plasma concentration of alpha-hANP. RESULTS: The plasma concentration of alpha-hANP increased sufficiently after the beginning of continuous intravenous infusion without any side effects, and the urine volume increased too. The administration of alpha-hANP induced a decrease in central venous pressure, pulmonary capillary wedged pressure and the pulmonary vascular resistance index. Systemic vascular resistance index and cardiac output remained unchanged. CONCLUSIONS: It is useful for the management of patients with associated volume overload following open-heart surgery because the administration of alpha-hANP decreases preload and facilitates satisfactory urination.
BACKGROUND: A cardiac hormone, alpha-human atrial natriuretic polypeptide (alpha-hANP), acts as a vasodilator and a diuretic by activating cyclic GMP formation. We studied the hemodynamic effects of continuous intravenous infusion of alpha-hANP on patients undergoing open-heart surgery. METHODS: A total of 15 patients, including 7 with CABG, 4 with AVR, 2 with CABG plus AVR, and 2 with AVR plus MVR were involved in the study. They underwent open-heart surgery in our institute between July 1996 and April 1997. The mean age of patients was 68 years, ranging from 63 to 77. A dosage of 0.05 microg/kg/min of alpha-hANP was administered to all patients on postoperative day 1. Hemodynamics and blood and urine samples were measured at the following times: 2 hours before continuous intravenous infusion of alpha-hANP, 0, 1, 2, 3, 6, 12 and 24 hours after continuous intravenous infusion. We concomitantly measured urine volume and the plasma concentration of alpha-hANP. RESULTS: The plasma concentration of alpha-hANP increased sufficiently after the beginning of continuous intravenous infusion without any side effects, and the urine volume increased too. The administration of alpha-hANP induced a decrease in central venous pressure, pulmonary capillary wedged pressure and the pulmonary vascular resistance index. Systemic vascular resistance index and cardiac output remained unchanged. CONCLUSIONS: It is useful for the management of patients with associated volume overload following open-heart surgery because the administration of alpha-hANP decreases preload and facilitates satisfactory urination.
Authors: Anand Kumar; Ramon Anel; Eugene Bunnell; Kalim Habet; Alex Neumann; David Wolff; Robert Rosenson; Mary Cheang; Joseph E Parrillo Journal: Intensive Care Med Date: 2004-04-07 Impact factor: 17.440