[The kidney in mechanical ventilation].
The negative effect of artificial ventilation with positive pressure on renal function, expresses itself as a decrease of water and sodium excretion, being directly related with the raise of intrathoracic pressure. Factors participating in this process are: lowering in cardiac output, arousal of sympathic nervous system, increase in vasopressin action, activation of renin-angiotensin-aldosterone system and decrease of atrial natriuretic peptide release. This disorder of hydromineral metabolism produces: Impairment of hemodynamic equilibrium, favors the increase of hypoxia and renal failure. The effects of mechanical ventilation on renal function can be attenuated with the adoption of the following measures: a) techniques (use of low levels of PEEP and early disconnection of respirator); b) therapeutic (dopamine 2-3 mcg/kg/min, rational use of diuretics and fluids); y c) monitoring of renal function and hydro-mineral equilibrium.
Gómez Rubí
J A
JA
Servicio de Medicina Intensiva, Hospital Universitario Virgen de la Arrixaca, Murcia.
Nicolás Franco
S
S
Buendia
J L
JL
Pardo Talavera
J C
JC
D000208:Acute Disease; D000818:Animals; D006801:Humans; D007668:Kidney / Q000502:physiology; D011652:Pulmonary Circulation / Q000502:physiology; D051437:Renal Insufficiency / Q000209:etiology*; D012121:Respiration, Artificial / Q000009:adverse effects*
El riñón en la ventilación mecánica.