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Ann Thorac Surg 1990;49:632-637
© 1990 The Society of Thoracic Surgeons

Articles

Atria1 pressure and hormonal and renal responses to acute cardiac tamponade

Markku Hynynen, MD*, Markku Salmenperä, MD, Ari L.J. Harjula, MD, Ilkka Tikkanen, MD, Frej Fyhrquist, MD, Jussi Heinonen, MD

Department of Anaesthesia, Department of Thoracic and Cardiovascular Surgery, and Fourth Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

Accepted for publication December 1, 1989.

* Address reprint requests to Dr Hynynen, Department of Anaesthesia, Helsinki University Central Hospital, Haartmaninkatu 4, SF-00290 Helsinki, Finland.

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.




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M. Hagiike, H. Maeta, H. Murakami, K. Okada, and H. Morita
Mechanism of biphasic response of renal nerve activity during acute cardiac tamponade in conscious rabbits
Am J Physiol Regulatory Integrative Comp Physiol, May 1, 1999; 276(5): R1232 - R1240.
[Abstract] [Full Text] [PDF]


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