Pulmonary-renal axis during positive-pressure ventilation.
Controlled mechanical ventilation with positive end-expiratory pressure (PEEP) is generally associated with decreases in urine volume and renal sodium excretion. The resulting positive sodium and water balance is an undesirable side effect of controlled mechanical ventilation with PEEP. The increase in intrathoracic pressure initiates a cascade of hemodynamic, neural, and hormonal changes which, in turn, stimulate the kidney to decrease the glomerular filtration rate and increase tubular reabsorption. The redundancy of these regulatory mechanisms makes it difficult to determine the involvement of only one or two single parameters as causative events of the phenomenon.
Kaczmarczyk
G
G
Clinic of Anesthesiology and Operative Intensive Medicine, Klinikum Rudolf Virchow, Free University of Berlin, Germany.
D000818:Animals; D009320:Atrial Natriuretic Factor / Q000502:physiology; D005110:Extracellular Space / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000294:innervation / Q000503:physiopathology*; D008168:Lung / Q000503:physiopathology*; D011175:Positive-Pressure Respiration; D012084:Renin-Angiotensin System / Q000502:physiology; D014667:Vasopressins / Q000502:physiology
D014667:Vasopressins; D009320:Atrial Natriuretic Factor