title: Efficacy of continuous low-dose human atrial natriuretic peptide given from the beginning of cardiopulmonary bypass for thoracic aortic surgery.
abstract: OBJECTIVE
  Cardiac surgery performed under cardiopulmonary bypass (CPB) causes abnormalities of the renin-angiotensin-aldosterone system, resulting in decreased urine output and an accumulation of water in the third space. We studied the efficacy of continuous low-dose human atrial natriuretic peptide (hANP) in patients undergoing thoracic aortic surgery.
  
  
  METHODS
  We divided 40 patients undergoing thoracic aortic surgery into two groups: the hANP group, which received 0.02 microg/kg per minute of hANP and the non-hANP group, which did not. The hemodynamics, urine output, intensive care unit (ICU) and hospital stay, bleeding volume, homologous blood transfusion volume, furosemide dose, corrected KCl volume, and postoperative respiratory, hepatic, and renal function were compared in the two groups.
  
  
  RESULTS
  The urine output during CPB and from CPB weaning to return to ICU was significantly better in the hANP group. The bleeding volume, homologous blood transfusion volume, furosemide dose, and corrected KCl volume were all significantly less in the hANP group.
  
  
  CONCLUSIONS
  These findings support the consensus that hANP exerts its diuretic effects to their full potential when administered continuously at low doses during thoracic aortic surgery. We found it to be effective for postoperative hemostasis and for preventing ischemic reperfusion injury.
authors.affiliation: Department of Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Iida
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
authors.forename: Masao
authors.initials: M
authors.lastname: Soeda
authors.forename: Nanao
authors.initials: N
authors.lastname: Negishi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kasamaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Saito
authors.forename: Jitsu
authors.initials: J
authors.lastname: Kato
authors.forename: Yukiyasu
authors.initials: Y
authors.lastname: Sezai
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass; D005260:Female; D005665:Furosemide / Q000008:administration & dosage; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D011189:Potassium Chloride / Q000008:administration & dosage; D014556:Urine
chemical_list: D011189:Potassium Chloride; D005665:Furosemide; D009320:Atrial Natriuretic Factor