Plasma vasopressin levels during and after cardiopulmonary bypass in man.

Medical biology Pub Date : 1986-01-01
O Viinamäki, L Nuutinen, R Hanhela, J Karinen, A Pekkarinen, J Hirvonen
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Abstract

The effect of cardiopulmonary bypass (CPB) using high dose fentanyl anaesthesia on the concentrations of plasma arginine vasopressin (pAVP), serum electrolytes and osmolality was studied in 12 patients by repeated sampling up to 4th postoperative day. These values were also followed in another 20 patients for the first postoperative day. Fentanyl abolished the pAVP response often seen in major operations but not that produced by CBP. The pAVP concentration 4.8 +/- 0.8 pg/ml immediately after sternotomy increased to 27.2 +/- 1.5 pg/ml (P less than 0.001) after 5-10 minutes on CPB. By the 4th postoperative day the pAVP levels had reached normal values. The main reason for the elevated pAVP concentrations seems to be the onset of CPB, which provokes a fall in mean arterial pressure leading to pAVP release.

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人体外循环期间和之后血浆加压素水平。
采用重复采样方法,观察高剂量芬太尼麻醉下体外循环(CPB)对12例患者术后第4天血浆精氨酸加压素(pAVP)、血清电解质及渗透压的影响。另外20例患者在术后第一天也遵循这些数值。芬太尼消除了大手术中常见的pAVP反应,但没有消除CBP产生的反应。CPB 5 ~ 10分钟后,切开胸骨后即刻的pAVP浓度(4.8 +/- 0.8 pg/ml)上升至27.2 +/- 1.5 pg/ml (P < 0.001)。术后第4天,血凝蛋白水平恢复正常。pAVP浓度升高的主要原因似乎是CPB的发作,CPB引起平均动脉压下降,导致pAVP释放。
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