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Báo cáo khoa học: " Science review: Natriuretic peptides in critical illness"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Science review: Natriuretic peptides in critical illness. | Critical Care October 2004 Vol 8 No 5 Witthaut Review Science review Natriuretic peptides in critical illness Rochus Witthaut Medizinische Klinik III Klinikum Kroellwitz Martin-Luther-University Halle-Wittenberg Halle Saale Germany Corresponding author Rochus Witthaut rochus.witthaut@medizin.uni-halle.de Published online 17 June 2004 This article is online at http ccforum.com content 8 5 342 2004 BioMed Central Ltd Critical Care 2004 8 342-349 DOI 10.1186 cc2890 Abstract The present review will cover the mechanisms of release and the potential pathophysiological role of different natriuretic peptides in critically ill patients. By focusing on the cardiovascular system possible implications of natriuretic peptides for diagnosis and treatment will be presented. In critical illness such as sepsis trauma or major surgery systemic hypotension and an intrinsic myocardial dysfunction occur. Impairment of the cardiovascular system contributes to poor prognosis in severe human sepsis. Natriuretic peptides have emerged as valuable marker substances to detect left ventricular dysfunction in congestive heart failure of different origins. Increased plasma levels of circulating natriuretic peptides atrial natriuretic peptide N-terminal pro-atrial natriuretic peptide brain natriuretic peptide and its N-terminal moiety N-terminal pro-brain natriuretic peptide have also been found in critically ill patients. All of these peptides have been reported to reflect left ventricular dysfunction in these patients. The increased wall stress of the cardiac atria and ventricles is followed by the release of these natriuretic peptides. Furthermore the release of atrial natriuretic peptide and brain natriuretic peptide might be triggered by members of the IL-6-related family and endotoxin in the critically ill. Apart from the vasoactive actions of circulating natriuretic peptides and their broad effects on the renal system anti-ischemic properties and immunological functions have been reported