Temporal changes in atrial natriuretic peptide (ANP) levels after resuscitation from traumatic hypotension

Brian Daley, Blaine Enderson, Karen S. Hunter, Edgar Cruz

Research output: Contribution to journalArticle

Abstract

Objective: Follow ANP in trauma patients with blood pressures < 90 mm Hg on admission and after resuscitation. ANP is a regulator of intravascular volume. Methods: Over three months, 15 hypotensive trauma patients had serum sampled on admission (ANP 1), and days 2 and 7 (ANP 2 and 3). ANP levels were assayed by radioimmunoassay (Pennisula Labs, Belmont, CA) in pg/ml. Results: Mean age was 55 years (25-84); 9 men/6 women. No patient died or developed ARDS, all were resuscitated by 24 hours. BP pH Hgb Lact Vol RBC ANP1 ANP 2 ANP3 mean 75 7.34 11.1 4.0 12,159 5.9 26.37 95.42 54.99 SD 10 0.07 1.88 2.1 10,468 4.8 14.17 40.0 34.83 Range 58- 7.19- 6.8- 1.8- 3,414- 0-14 2.72- 24.88- 30.12 90 7.43 14.9 9.5 36,057 46.64 164.44 -129.98 SD = standard deviation, Hgb = hemoglobin in gm/dl, Lact = lactate (mg/dl), Vol = cc's/1st 24 hours, RBC = units blood/1st 24 hours. ANP1, ANP2, and ANP3 levels were significantly different from each other (p<0.05, t - test). BP pH Hgb Lact Vol RBC Temp Cr WBC r 0.55 0.07 -0.41 0.52 0.15 0.26 -0.45 0.40 -0.13 Temp = temperature, Cr = creatinine, WBC = white blood cell count. Maximum increases in ANP were correlated with degree of hypotension and lactate production, but did not correlate with volume of resuscitation or red cell transfusion. Conclusions: ANP, secreted in response to resuscitation after injury, peaks at 48 hours. The degree of response correlated better with the physiologic derangement more than measures of resuscitation. In view of these findings ANP is already stimulated in trauma patients, and supplementation may not improve fluid balance.

Original languageEnglish (US)
JournalCritical Care Medicine
Volume27
Issue number1 SUPPL.
StatePublished - Dec 1 1999

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Atrial Natriuretic Factor
Resuscitation
Hypotension
Wounds and Injuries
Lactic Acid
Water-Electrolyte Balance
Leukocyte Count
Radioimmunoassay
Creatinine
Hemoglobins
Blood Pressure
Temperature
Serum

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Temporal changes in atrial natriuretic peptide (ANP) levels after resuscitation from traumatic hypotension. / Daley, Brian; Enderson, Blaine; Hunter, Karen S.; Cruz, Edgar.

In: Critical Care Medicine, Vol. 27, No. 1 SUPPL., 01.12.1999.

Research output: Contribution to journalArticle

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abstract = "Objective: Follow ANP in trauma patients with blood pressures < 90 mm Hg on admission and after resuscitation. ANP is a regulator of intravascular volume. Methods: Over three months, 15 hypotensive trauma patients had serum sampled on admission (ANP 1), and days 2 and 7 (ANP 2 and 3). ANP levels were assayed by radioimmunoassay (Pennisula Labs, Belmont, CA) in pg/ml. Results: Mean age was 55 years (25-84); 9 men/6 women. No patient died or developed ARDS, all were resuscitated by 24 hours. BP pH Hgb Lact Vol RBC ANP1 ANP 2 ANP3 mean 75 7.34 11.1 4.0 12,159 5.9 26.37 95.42 54.99 SD 10 0.07 1.88 2.1 10,468 4.8 14.17 40.0 34.83 Range 58- 7.19- 6.8- 1.8- 3,414- 0-14 2.72- 24.88- 30.12 90 7.43 14.9 9.5 36,057 46.64 164.44 -129.98 SD = standard deviation, Hgb = hemoglobin in gm/dl, Lact = lactate (mg/dl), Vol = cc's/1st 24 hours, RBC = units blood/1st 24 hours. ANP1, ANP2, and ANP3 levels were significantly different from each other (p<0.05, t - test). BP pH Hgb Lact Vol RBC Temp Cr WBC r 0.55 0.07 -0.41 0.52 0.15 0.26 -0.45 0.40 -0.13 Temp = temperature, Cr = creatinine, WBC = white blood cell count. Maximum increases in ANP were correlated with degree of hypotension and lactate production, but did not correlate with volume of resuscitation or red cell transfusion. Conclusions: ANP, secreted in response to resuscitation after injury, peaks at 48 hours. The degree of response correlated better with the physiologic derangement more than measures of resuscitation. In view of these findings ANP is already stimulated in trauma patients, and supplementation may not improve fluid balance.",
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N2 - Objective: Follow ANP in trauma patients with blood pressures < 90 mm Hg on admission and after resuscitation. ANP is a regulator of intravascular volume. Methods: Over three months, 15 hypotensive trauma patients had serum sampled on admission (ANP 1), and days 2 and 7 (ANP 2 and 3). ANP levels were assayed by radioimmunoassay (Pennisula Labs, Belmont, CA) in pg/ml. Results: Mean age was 55 years (25-84); 9 men/6 women. No patient died or developed ARDS, all were resuscitated by 24 hours. BP pH Hgb Lact Vol RBC ANP1 ANP 2 ANP3 mean 75 7.34 11.1 4.0 12,159 5.9 26.37 95.42 54.99 SD 10 0.07 1.88 2.1 10,468 4.8 14.17 40.0 34.83 Range 58- 7.19- 6.8- 1.8- 3,414- 0-14 2.72- 24.88- 30.12 90 7.43 14.9 9.5 36,057 46.64 164.44 -129.98 SD = standard deviation, Hgb = hemoglobin in gm/dl, Lact = lactate (mg/dl), Vol = cc's/1st 24 hours, RBC = units blood/1st 24 hours. ANP1, ANP2, and ANP3 levels were significantly different from each other (p<0.05, t - test). BP pH Hgb Lact Vol RBC Temp Cr WBC r 0.55 0.07 -0.41 0.52 0.15 0.26 -0.45 0.40 -0.13 Temp = temperature, Cr = creatinine, WBC = white blood cell count. Maximum increases in ANP were correlated with degree of hypotension and lactate production, but did not correlate with volume of resuscitation or red cell transfusion. Conclusions: ANP, secreted in response to resuscitation after injury, peaks at 48 hours. The degree of response correlated better with the physiologic derangement more than measures of resuscitation. In view of these findings ANP is already stimulated in trauma patients, and supplementation may not improve fluid balance.

AB - Objective: Follow ANP in trauma patients with blood pressures < 90 mm Hg on admission and after resuscitation. ANP is a regulator of intravascular volume. Methods: Over three months, 15 hypotensive trauma patients had serum sampled on admission (ANP 1), and days 2 and 7 (ANP 2 and 3). ANP levels were assayed by radioimmunoassay (Pennisula Labs, Belmont, CA) in pg/ml. Results: Mean age was 55 years (25-84); 9 men/6 women. No patient died or developed ARDS, all were resuscitated by 24 hours. BP pH Hgb Lact Vol RBC ANP1 ANP 2 ANP3 mean 75 7.34 11.1 4.0 12,159 5.9 26.37 95.42 54.99 SD 10 0.07 1.88 2.1 10,468 4.8 14.17 40.0 34.83 Range 58- 7.19- 6.8- 1.8- 3,414- 0-14 2.72- 24.88- 30.12 90 7.43 14.9 9.5 36,057 46.64 164.44 -129.98 SD = standard deviation, Hgb = hemoglobin in gm/dl, Lact = lactate (mg/dl), Vol = cc's/1st 24 hours, RBC = units blood/1st 24 hours. ANP1, ANP2, and ANP3 levels were significantly different from each other (p<0.05, t - test). BP pH Hgb Lact Vol RBC Temp Cr WBC r 0.55 0.07 -0.41 0.52 0.15 0.26 -0.45 0.40 -0.13 Temp = temperature, Cr = creatinine, WBC = white blood cell count. Maximum increases in ANP were correlated with degree of hypotension and lactate production, but did not correlate with volume of resuscitation or red cell transfusion. Conclusions: ANP, secreted in response to resuscitation after injury, peaks at 48 hours. The degree of response correlated better with the physiologic derangement more than measures of resuscitation. In view of these findings ANP is already stimulated in trauma patients, and supplementation may not improve fluid balance.

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