The Effect of Hemorrhage and Resuscitation on Serum Levels of Immunoreactive Atrial Natriuretic Factor

To determine if atrial natriuretic factor (ANF) might have a role in blood volume regulation during hypovolemia, the serum level was measured before and after hemorrhage and resuscitation (RESUS) in a porcine shock model. Hemorrhage of 40% of the blood volume produced significant (p less than 0.01) decreases in mean arterial pressure, central venous pressure, and cardiac output and a significant increase in heart rate (HR), plasma renin activity, and catecholamines (p less than 0.01). Hemorrhage was also associated with a significant increase in ANF (p less than 0.05). All parameters except HR returned to baseline values with RESUS. The rise in ANF associated with moderate hemorrhage was unexpected, but may have been due to the profound tachycardia or decreased degradation during shock. Sodium excretion and urine flow increased significantly with RESUS without an associated increase in ANF, suggesting that ANF may not be involved in the early phase of postresuscitation diuresis.