Clinical Significance of Elevated Natriuretic Peptide Levels and Cardiopulmonary Parameters After Subarachnoid Hemorrhage

• NAKAMURA Tatsuya

  Department of Emergency and Critical Care Medicine, Nara Medical University

• OKUCHI Kazuo

  Department of Emergency and Critical Care Medicine, Nara Medical University

• MATSUYAMA Takeshi

  Department of Emergency and Critical Care Medicine, Nara Medical University

• FUKUSHIMA Hidetada

  Department of Emergency and Critical Care Medicine, Nara Medical University

• SEKI Tadahiko

  Department of Emergency and Critical Care Medicine, Nara Medical University

• KONOBU Toshifumi

  Department of Emergency and Critical Care Medicine, Nara Medical University

• NISHIO Kenji

  Department of Emergency and Critical Care Medicine, Nara Medical University

抄録

Daily changes in serum concentrations of natriuretic peptides and various cardiopulmonary parameters were measured after the onset of subarachnoid hemorrhage (SAH) to investigate the pathogenesis of the cardiac and pulmonary consequences in 15 patients with acute phase SAH, divided into the control group (n = 5) with consciousness continuously preserved from SAH onset to admission, and the consciousness disturbance group (n = 10). Daily changes in serum A-type and B-type natriuretic peptides (ANP and BNP, respectively) were measured for 10 days, and intrathoracic blood volume index and extravascular lung water index (EVLWI) were measured for 5 days by the single transpulmonary thermodilution method. Natriuretic peptides in the consciousness disturbance group showed significantly higher values during the 10-day period, with ANP 119.2 ± 12.4 pg/ml (mean ± standard error of the mean, p = 0.005) on day 2 and BNP 354.1 ± 80.3 pg/ml (p = 0.009) on day 1. EVLWI showed higher values in the consciousness disturbance group compared to the control group throughout the 5-day period. The increases in natriuretic peptide levels and increase in pulmonary extravascular water content found in SAH patients with consciousness disturbance show that load on the left ventricle or atrium as well as pulmonary capillary pressure are increased immediately after onset, supporting the contention that excessive release of catecholamines occurs at this time.<br>

収録刊行物

• Neurologia medico-chirurgica

  Neurologia medico-chirurgica 49 (5), 185-192, 2009

  一般社団法人 日本脳神経外科学会

キーワード

• subarachnoid hemorrhage
• B-type natriuretic peptide
• A-type natriuretic peptide
• transpulmonary thermodilution
• pulmonary edema

詳細情報

• CRID: 1390282680030041472
• NII論文ID: 10025947641
• NII書誌ID: AN00358613
• DOI: 10.2176/nmc.49.185
• ISSN: 13498029
• ISSN: 04708105
• Web Site: http://www.jstage.jst.go.jp/article/nmc/49/5/49_5_185/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2009289701
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可