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J Appl Physiol 73: 962-967, 1992;
8750-7587/92 $5.00
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Journal of Applied Physiology, Vol 73, Issue 3 962-967, Copyright © 1992 by American Physiological Society

ARTICLES

ACE inhibition facilitates sodium and water excretion during PEEP in conscious volume-expanded dogs

G. Kaczmarczyk, R. Rossaint, C. Altmann, K. Falke, R. Mohnhaupt and H. W. Reinhardt
Clinic of Anesthesiology and Operative Intensive Medicine, Universitatsklinikum Rudolf Virchow Standort Charlottenburg, Free University of Berlin, Federal Republic of Germany.

Increased activity of the renin-angiotensin system may be involved in sodium and water retention during controlled mechanical ventilation (CMV) with positive end-expiratory pressure (PEEP). We therefore evaluated renal, hemodynamic, and hormonal effects of an acute angiotensin-converting enzyme inhibition (ACEI) during PEEP and extracellular volume expansion in five trained chronically tracheotomized dogs. Three protocols were performed: control, 4 h spontaneous breathing with continuous positive mean airway pressure (Paw) of 4 cmH2O (CPAP 4); CMV 20, CPAP for 1st h, CMV with 20 cmH2O Paw for 2 h (2nd and 3rd h), and 1 h of CPAP (4th h); and CMV20-ACEI, ACEI (Ramipril, 2 mg/kg body wt) followed by the same protocol as in CMV 20. During control, sodium excretion (UNaV) and urine volume (V) increased continuously to 56.2 +/- 2.7 (SE) mumol.min-1.kg body wt-1 and 482 +/- 23 microliters.min-1.kg body wt-1, respectively. UNaV and V increased less during PEEP in CMV 20 and CMV 20-ACEI. However, significantly more sodium and water were retained in CMV 20 than in CMV 20-ACEI (2.3 +/- 0.3 vs. 1.0 +/- 0.3 mmol/kg body wt, and 20 +/- 3 vs. 11 +/- 2 ml/kg body wt) because of a decrease of glomerular filtration rate and fractional UNaV in CMV 20. Heart rate did not change in control, CMV 20, or CMV 20-ACEI. Mean arterial pressure increased during control by 13 mmHg, did not change during CMV 20, and was decreased by 7 mmHg in CMV 20-ACEI.(ABSTRACT TRUNCATED AT 250 WORDS)


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 Am. J. Physiol. Renal Physiol.Home page
M. O. Krebs, T. Krohn, W. Boemke, R. Mohnhaupt, and G. Kaczmarczyk
Renal and hemodynamic effects of losartan in conscious dogs during controlled mechanical ventilation
Am J Physiol Renal Physiol, March 1, 1999; 276(3): F425 - F432.
[Abstract] [Full Text] [PDF]


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