Berkenstadt H, Rosenthal T, Peleg E, Segal E, Hackshaw A, Ben-Ari G, Perel A
Department of Anesthesiology and Intensive Care, Chaim Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Chest. 1999 Jan;115(1):130-4. doi: 10.1378/chest.115.1.130.
The influence of occlusion of the thoracic aorta by an intraluminal balloon on plasma atrial natriuretic peptide (ANP) levels was evaluated in humans.
The changes in plasma ANP and plasma norepinephrine levels, and hemodynamic parameters were measured in 10 patients under general anesthesia undergoing regional chemotherapy treatment involving the 15-min inflation and subsequent deflation of an intraaortic balloon.
The hemodynamic changes observed were similar to those seen during aortic clamping and declamping in patients undergoing vascular surgery. Plasma ANP levels (median+/-SD) measured 1 min after inflation (146+/-117 pg/mL) and 1 min after deflation (168+/-189 pg/mL) of the aortic balloon were significantly higher than baseline values (83+/-55 pg/mL), with a mean increase, respectively, of 92% and 97% (95% confidence intervals [CI], 50 to 147% and 53 to 152%). Plasma ANP levels were still elevated 30 min after deflation (121+/-94 pg/mL), a 56% increase (95% CI, 21 to 100%), although the hemodynamic parameters had already returned to their baseline levels. There was no evidence that the hemodynamic variables were associated with changes in plasma ANP levels (all p values > 0.30). In addition, there was no evidence of an association between plasma ANP and plasma norepinephrine levels at any of the four individual sampling points (p > 0.17). Thirty minutes after deflation, however, norepinephrine levels were higher than baseline values.
The changes in plasma ANP levels after aortic occlusion and reinstitution of blood flow may be dependent on parameters other than atrial stretch and pressure.
评估腔内球囊阻断胸主动脉对人体血浆心房利钠肽（ANP）水平的影响。
对10例全身麻醉下接受区域化疗的患者进行了研究，期间通过主动脉内球囊充气15分钟随后放气，测量血浆ANP、血浆去甲肾上腺素水平及血流动力学参数的变化。
观察到的血流动力学变化与血管手术患者主动脉夹闭和松开时的变化相似。主动脉球囊充气后1分钟（146±117 pg/mL）和放气后1分钟（168±189 pg/mL）测得的血浆ANP水平显著高于基线值（83±55 pg/mL），平均分别升高92%和97%（95%置信区间[CI]，50%至147%和53%至152%）。放气后30分钟血浆ANP水平仍升高（121±94 pg/mL），升高56%（95%CI，21%至100%），尽管血流动力学参数已恢复至基线水平。没有证据表明血流动力学变量与血浆ANP水平变化相关（所有p值>0.30）。此外，在四个单独采样点中的任何一点，血浆ANP与血浆去甲肾上腺素水平之间均无关联证据（p>0.17）。然而，放气后30分钟，去甲肾上腺素水平高于基线值。
主动脉阻断及血流恢复后血浆ANP水平的变化可能取决于心房牵张和压力以外的参数。
