title: [Usefulness of human atrial natriuretic peptide (hANP) on perioperative management for liver resection].
abstract: BACKGROUND
  We investigated whether postoperative renal function was affected by a low central venous pressure (CVP) management induced by restricted fluid administration in order to reduce blood loss during liver resection. In addition, we examined whether the continuous low-dose infusion of human atrial natriuretic peptide (hANP) during operation improved perioperative hemodynamic status and postoperative renal function in surgical patients for hepatectomy who were managed to maintain CVP at a low level.
  
  
  METHODS
  The 39 subjects underwent liver resection, and they were randomized to receive 0.025 microg x kg(-1) x min(-1) of hANP (n = 19) or placebo (saline, n = 20) infusion during surgery. Blood samples for measurement of serum concentrations of BUN and creatinine were taken before surgery, at admission to ICU and on postoperative day 1.
  
  
  RESULTS
  The mean volume of fluid infusion and urinary output were significantly higher in the hANP group, but there were no differences in the values of BUN and creatinine during perioperative period between the two groups.
  
  
  CONCLUSIONS
  A restricted fluid infusion strategy during liver resection did not affect postoperative renal function and the continuous infusion of hANP showed no improvement effects on BUN and creatinine concentrations.
authors.affiliation: Department of Anesthesiology, School of Medicine, Iwate Medical University, Morioka 020-8505.
authors.forename: Yuichiroh
authors.initials: Y
authors.lastname: Tamura
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nagata
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Sato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nitta
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000627:therapeutic use*; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006498:Hepatectomy; D006801:Humans; D008297:Male; D019990:Perioperative Care
chemical_list: D009320:Atrial Natriuretic Factor; D003404:Creatinine