Atrial natriuretic peptide and blood volume during red cell transfusion in preterm infants

Article Abstract:

Premature infants with low birth weights may be transfused with red blood cells to restore blood loss and treat anemia (a decrease in red blood cells). A deficiency in red blood cells may be more accurately estimated by measuring the mass rather than the volume of cells. However, red blood cell transfusion may be complicated by intraventricular hemorrhage, or bleeding within the ventricles of the brain. The expansion of blood volume triggers the release of atrial natriuretic hormone from the heart atria. Blood levels of atrial natriuretic hormone have been observed to increase in infants with respiratory distress syndrome, increased sodium intake, and patent ductus arteriosus (an abnormal opening of the passage between the main pulmonary artery and the aorta). The levels of atrial natriuretic hormone have been correlated with changes in blood volume in newborns, suggesting that this hormone may serve as a sensitive indicator of these changes. The effect of red blood cell transfusion on the levels of atrial natriuretic hormone was assessed in eight premature infants. Red blood cell transfusion increased the mass, volume, and numbers of red blood cells, but decreased the plasma volume. The total blood volume, levels of atrial natriuretic hormone, urine flow, and urinary excretion of sodium remain unchanged. These findings suggest that red blood cell transfusion of less than 10 milliliters of red cells per kilogram of body weight does not cause expansion of blood volume or atrial natriuretic peptide levels, and therefore does not affect the cardiovascular system. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Infants (Premature), Premature infants, Blood, Blood transfusion

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Atrial natriuretic factor and postnatal diuresis in respiratory distress syndrome

Article Abstract:

Diuresis (excretion of body water as large volumes of urine) occurs in the first days of life in newborns with respiratory distress syndrome. This diuresis causes a body deficit of sodium and water, but may actually be essential for improved lung function; the mechanisms underlying the diuresis are not known. Atrial natriuretic factor (ANF) is a newly discovered hormone made by the atria (the upper heart chambers) that stimulates water and sodium loss via the urine. The hormone is stimulated in response to increased blood volume in the atria. The association between ANF secretion and the initiation and maintenance of diuresis in newborns was evaluated in 13 premature infants. Levels of ANF rose significantly in the interval between 12 hours after birth and the time period of 24 to 36 hours after birth, and then fell before the third measurement, taken between 48 and 60 hours. Diuresis began at an average of 27 hours after birth, and ANF levels tended to be higher before diuresis onset. Urine volume correlated with levels of ANF, suggesting that the hormone has some role in the maintenance of diuresis. Respiratory data suggested that more severe lung disease correlated with a later start of diuresis. The results suggest that atrial natriuretic factor is important, but not necessarily critical, in initiating diuresis onset in premature infants. Further research on the many factors which affect kidney function and diuresis in premature infants is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infants (Newborn), Newborn infants, Respiratory distress syndrome, Diuresis

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