Effect of PEEP ventilation on renal function, plasma renin, aldosterone, neurophysins and urinary ADH, and prostaglandins.

摘要: To explore the main factors which could be involved in fluid retention induced by continuous positive pressure ventilation (CPPV), hemodynamics, renal, and hormonal parameters were measured seven intensive care patients during three consecutive 60-min periods; one of intermittent (IPPV), CPPV (PEEP 10 cmH2O), finally IPPV. During CPPV, a 15% decrease cardiac output was observed, without alteration arterial or right atrial transmural pressure. In addition, decreases observed urinary 34%, glomerular filtration rate 19%, renal blood flow 32%, sodium excretion 33%, potassium 26%. There no change fractional free water. Institution PEEP also led to significant increase plasma renin activity, aldosterone, antidiuretic hormone, variation neurophysins prostaglandins E F alpha. All changes that occurred reversed when withdrawn. It is concluded short-term effect mainly due hemodynamic impairment function. The water- sodium-retaining systems are stimulated participate more prolonged respiratory support with PEEP.