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High frequency jet ventilation is associated with increased levels of plasma -atrial natriuretic peptide – a preliminary study

[La ventilation en jet à haute fréquence est associée à une augmentation des niveaux plasmatiques de peptides natriurétiques auriculaires – une étude préliminaire]

Atsuko Nagatani, MD^*, Sadayo Niiya, MD and Koji Sumikawa, MD

^* From the Departments of Anesthesiology, National Nagasaki Medical Center,
Isahaya-Sogo Hospital, and
the Nagasaki University School of Medicine, Nagasaki, Japan.

Address correspondence to: Dr. Atsuko Nagatani, Department of Anesthesiology, National Nagasaki Medical Center, Kubara 2-1001-1 Oomura city, Nagasaki 856-8562, Japan. Phone: +81-957-52-3121; Fax: +81-957-54-0292; E-mail tulipcat{at}nifty.com

Purpose: To determine if high frequency jet ventilation (HFJV) influences the secretion of -atrial natriuretic peptide (- ANP).

Methods: Sixteen patients undergoing otolaryngeal surgery were studied. Nine patients were subjected to intermittent positive pressure ventilation (IPPV), and seven patients underwent HFJV. Blood samples were drawn for the measurement of plasma -ANP levels and blood gases before anesthesia, and at 30-min after starting either type of ventilation. The study was started at 2:00 p.m., and was completed before surgery. The plasma concentration of -ANP was assayed by radioimmunoassay.

Results: There were no significant differences in mean arterial pressure, heart rate, oxygenation index and PaCO₂ between the two groups. IPPV was not associated with any changes in plasma -ANP levels, whereas HFJV was associated with significantly increased plasma -ANP levels (from 60.0 ± 5.7 pg•mL^-1 before anesthesia to 112.0 ± 11.6 pg•mL^-1 after ventilation, P < 0.01). The urine output of the HFJV patients was significantly greater than that of the IPPV patients (P < 0.05).

Conclusion: These preliminary results suggest that HFJV is associated with a significant increase in plasma ANP and in urine output in anesthetized patients.