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The Annals of Thoracic Surgery, Vol 49, 632-637, Copyright © 1990 by The Society of Thoracic Surgeons
M Hynynen, M Salmenpera, AL Harjula, I Tikkanen, F Fyhrquist and J Heinonen
The effect of acute cardiac tamponade on atrial pressures, plasma atrial
natriuretic factor concentration and renin activity, and renal water and
electrolyte excretion was studied in pigs loaded intravenously with
hydroxyethyl starch and maintained on a continuous intravenous infusion of
isotonic saline solution. Saline solution was infused into the pericardial
space in 6 anesthetized pigs until a predetermined decrease of 20% in mean
arterial pressure was achieved. Another 6 sham-treated pigs served as
controls. Tamponade increased atrial intracavitary pressures but decreased
atrial transmural (distending) pressures. These changes in atrial pressures
were reversed after release of tamponade. Changes in plasma atrial
natriuretic factor concentration correlated positively with changes in
atrial transmural pressures. Tamponade increased plasma renin activity and
decreased urine flow and renal sodium and potassium excretion, and release
of tamponade reversed these changes. Thus, the tamponade-induced reduction
in atrial distention is associated with hormonal changes, which may
contribute to the reductions in diuresis and natriuresis observed in this
connection.
ARTICLES
Atrial pressure and hormonal and renal responses to acute cardiac tamponade
Department of Anaesthesia, Helsinki University Central Hospital, Finland.
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