Key result
Cardiac surgery raises serum pro-ANP but levels show no correlation with hemodynamics or fluid balance.
Why the study?
The correlations between volemic status and serum pro-ANP in cardiac surgical patients were not well defined.
Does volemic status correlate with serum pro-ANP levels in cardiac surgical patients?
Observational (n=30)
Does volemic status correlate with serum pro-ANP levels in cardiac surgical patients?
Serum pro-ANP increases after cardiopulmonary bypass but does not correlate with intraoperative volemic status or fluid balance in cardiac surgical patients.
Pro-ANP rise after cardiac surgery does not track volemic status; hypothesis-generating and should not yet guide fluid management.
Objective. To identify the correlations between volemic status and serum pro-ANP. Material and methods. There were 30 cardiac surgical patients. Hemodynamic monitoring included stroke volume variation, stroke volume, and cardiac output. Serum pro-ANP and volemic status were intraoperatively analyzed at 8 stages including Teboul tests. Results. Serum pro-ANP at the end of surgery was 2.27 [1.5; 2.5] times higher compared to the baseline value. At the beginning of surgery serum pro-ANP was 102 [89; 185] pg/ml, at the end of surgery — 276 [171; 324] pg/ml. The majority of patients were non-responders according to Teboul test after induction of anesthesia and at the end of surgery. Serum pro-ANP was similar before and after functional tests. Stroke volume variation was 12% [8; 15] at the end of cardiopulmonary bypass and 5-10% in other points. Cumulative fluid balance was 1830 [1440; 2400] ml. No correlations between infusion rate, volume and serum pro-ANP were observed. Conclusion. Serum pro-ANP increased after cardiopulmonary bypass regardless of type and duration of surgery. No correlations between functional tests, hemodynamics, fluid balance and serum pro-ANP were detected.
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Akselrod et al. (2023) conducted an observational in Cardiac surgery (n=30). Volemic status was evaluated on Correlation between volemic status and serum pro-ANP. Serum pro-ANP increased 2.27-fold by the end of cardiac surgery compared to baseline, but showed no correlation with functional tests, hemodynamics, or fluid balance.
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