Low-dose continuous infusion of human atrial natriuretic peptide during and after cardiac surgery

Background. We evaluated the effects of human atrial natriuretic peptide (hANP) during cardiopulmonary bypass (CPB). Methods. Forty patients undergoing coronary artery bypass grafting were investigated, A group of patients given hANP for 24 hours from the start of CPB (hANP group) was compared with a non-hANP group. Parameters examined were hemodynamics, urine volume, dosage of furosemide, respiratory index, pleural effusion, ANP, cyclic guanosine monophosphate, renin activity (renin), angiotensin-II, aldosterone, and glomerular filtration rate. Results. Central venous pressure, systemic vascular resistance index, and pulmonary vascular resistance index were significantly lower in the hANP group than in the non-hANP group, The hANP group showed significantly higher levels of ANP, cyclic guanosine monophosphate, glomerular filtration rate, and respiratory index, and significantly lower levels of renin, angiotensin-II, aldosterone, and pleural effusion, as compared with the non-hANP group, The dosage of furosemide was significantly lower and the urine volume was significantly larger in the hANP group. Conclusions. hANP can satisfactorily compensate for the shortcomings of CPB by decreasing the peripheral vascular resistance, suppressing the renin-angiotensin-aldosterone system, and exerting a strong diuretic effect, (C) 2000 by The Society of Thoracic Surgeons.