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OBJECTIVES: Acute kidney injury is a common complication after aortic surgery. Carperitide, a human atrial natriuretic peptide, was reported to be effective for preventing acute kidney injury after cardiac surgery. However, most studies were from single centers, and results of meta-analyses are subject to publication bias. The aim of the present study was to investigate whether carperitide preserved renal function in patients undergoing cardiovascular surgery. DESIGN: Retrospective cohort study. SETTING: Participating hospitals (N = 281) in a national database from 2010 to 2013. PARTICIPANTS: Adult patients (N = 47,032) who underwent cardiovascular surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The main intervention variable investigated was the use of carperitide on the day of surgery. Assessed outcomes included receiving renal replacement therapy within 21 days of surgery and in-hospital mortality. Data were available for 47,032 patients, of whom 2,186 (4.6%) received carperitide on the day of surgery. Multivariate logistic regression analysis revealed that carperitide was significantly associated with a greater likelihood of receiving renal replacement therapy within 21 days of surgery, but not with in-hospital mortality. CONCLUSIONS: In patients undergoing cardiovascular surgery, carperitide significantly increased the odds of receiving renal replacement therapy within 21 days after surgery.

Asunto(s)

Aneurisma de la Aorta Torácica/tratamiento farmacológico , Aneurisma de la Aorta Torácica/cirugía , Factor Natriurético Atrial/efectos adversos , Procedimientos Quirúrgicos Cardíacos/tendencias , Complicaciones Posoperatorias/inducido químicamente , Terapia de Reemplazo Renal/tendencias , Anciano , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/terapia , Estudios Retrospectivos

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Objective To investigate the regularity and clinical significance of cortisol(Cor),adrenocorticotrophic hormone(ACTH),atrial natriuetic peptide(ANP) and interleukin-6(IL-6) changes before and after operation stress.Methods The ACTH,Cor,ANP and IL-6 levels in 18 children with abdominal neoplasms(12 male and 6 female,8 cases with sacrococcygeal teratoma,5 cases with hepatoblastoma,and 5 cases with nephroblastoma) were measured before and after operation(24 hours before operation;4,24,48,and 72 hours after operation).Eighteen children were divided into the study group and the control group.The children in the former group were accompanied with stress ulcer,intestinal obstruction and infection shock or even death after operations,while the children in the later group recovered without any complication.The ACTH,Cor,ANP in serum were measured by radioactive immune analysis(RIA) assay,and serum IL-6 level were measured by enzyme linked immunosorbent assay(ELISA).Results In 2 groups,serum levels of ACTH,Cor,ANP,IL-6 increased significantly 4 h after operation.The changes in ACTH and ANP were similar in 2 groups.Cor in the control group reached its peak 24 h after operation,and then decreased gradually to the pre-operation levels 72 h after operation;IL-6 reached its peak 4 h after operation,and then decreased slowly.It was still at a high level in 48 h after operation,and then decreased to pre-operation levels 72 h after operation.But serum Cor,IL-6 in the study group slightly increased 24 h after operation,and were apparently higher than those in the control group(Pa

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To observe the influence of neuregulin-1 on the cardiac function of post-myocardial infarction rats. Methods Left ventricular MI was created in Sprague-Dawley rats by ligation of the left anterior descending coronary. Six months after the operation, rats were evaluated with echocardiology methods. 36 rats that had an infarct area and a EF around 60% were randomized into 3 groups: MI group(n=12) were injected a blank vehicle fluid intravenously for 5 days, after which they continued to be raised on standard food and water for 30 days. MI+NRG group(n=12), received NRG-110μg·kg-1 intravenously for 5 days, after which they continued to be raised on standard food and water for 30 days. MI+Capt group (n=12) received captopril orally (dissolved in their drinking water 2g/L) for 30days, after which tap water substituted the solution for 5 days. Final echocardiographic and hemodynamic measurements were made at the end of 1 month of therapy. Total RNA was extracted from frozen left ventricular tissues, and was reverse transcribed into firststrand PCR was performed with primers for BNP、 ANP. Results Rats treated with neuregulin had a smaller LVDs (P=0.014), a betterLVEF (P=0.004),and a tendency towards less lung perfusion than untreated rats. Neuregulin decreased the expression of ANP mRNA in the ventricle (P=0.025).Conclusion Neuregulin markedly improved the cardiac function of rats that survived myocardial infarction,and decreased the expression of ANP mRNA in the ventricle.