ABSTRACT
BACKGROUND: We evaluated the cardiovascular effects of human atrial natriuretic peptide (hANP) in the pediatric recipients undergoing renal transplantation. METHODS: Anesthesia was maintained by inhalation of nitrous-oxide and isoflurane in oxygen. Intravenous infusion of hANP at a rate of 0.05 microg x kg(-1) x min(-1) was started on the anastomosis of the renal artery after the fresh frozen plasma had been loaded to achieve PCWP above 17 mmHg. We examined cardiovascular changes by using a pulmonary artery catheter and transesophageal echocardiography. The measurements were done before and after 15 minutes of hANP infusion. RESULTS: An increase in CI and a reduction in PCWP were significant. CONCLUSIONS: The low-dose infusion of hANP was useful in pediatric recipients undergoing renal transplantation for the optimal anesthetic care in view of the improvement of cardiovascular functions.
Subject(s)
Atrial Natriuretic Factor/administration & dosage , Cardiac Output , Intraoperative Care , Kidney Transplantation , Pulmonary Wedge Pressure , Adolescent , Anesthesia, Inhalation , Catheterization, Swan-Ganz , Child , Child, Preschool , Echocardiography, Transesophageal , Female , Humans , Infusions, Intravenous , MaleABSTRACT
BACKGROUND: We evaluated the cardiovascular effects of human atrial natriuretic peptide (hANP) in the recipients of renal transplantation. METHODS: Anesthesia was maintained by inhalation of nitrous-oxide and isoflurane in oxygen, with epidural block. The recipients were divided into three groups; one group received no hANP infusion as control and the other groups received continuous infusion of hANP at the rate of either 0.05 microg x kg(-1) x min(-1) or 0.1 microg x kg(-1) x min(-1). Intravenous infusion of hANP was started at the anastomosis of renal artery after the fresh frozen plasma was loaded to achieve PCWP over 17 mmHg. In each group, we examined cardiovascular changes by using a pulmonary artery catheter and transesophageal echocardiography. The measurements were done before and after 15 minutes of hANP infusion. RESULTS: In comparison with control, the decreases in PCWP and CVP were significant in the 0.1 microg x kg(-1) x min(-1) group. An increase in CI and the reduction of CVP were significant in 0.05 microg x kg(-1) x min(-1) group, when compared with control group. In the 0.1 microg x kg(-1) x min(-1) group, the reductions of PCWP and CVP and MAP were significant, but the significant increase in CI was characteristic in the 0.05 microg x kg(-1) x min(-1) group. CONCLUSIONS: We conclude that the low-dose infusion of hANP in the recipients of renal transplantation is useful for the optimal anesthetic care because of the cardiovascular improvement.