POSITIVE END EXPIRATORY PRESSURE VENTILATION, RENAL-FUNCTION AND RENIN

  • 1 January 1979
    • journal article
    • research article
    • Vol. 11  (2) , 58-62
Abstract
Positive end expiratory pressure (PEEP) during respirator therapy can impair renal function by altering renal hemodynamics or by increasing antidiuretic hormone secretion. The effect of the commonly used 10 cm H2O PEEP for 2 h on renal function and on plasma renin activity was studied in 11 intensive care patients. During the examination period, the patients received analgesic, sedative and muscle relaxant drugs, but no diuretics. PEEP decreased the mean urinary output by 21%. Urinary specific gravity and osmolality increased. Urinary Na excretion decreased along with urinary volume. The creatinine clearance decreased slightly, but free water clearance became less negative suggesting reduced ability of tubules to concentrate urine during PEEP. The plasma renin activity was not altered significantly by PEEP, nor did the urinary Na/K ratio change. The water retention induced by PEEP may not be caused by the increased secretion of aldosterone. Impaired renal function in critically ill patients and water retention may be caused by 10 cm H2O PEEP.