Intermittent Positive-Pressure Respiration and ADH

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To the Editor: In an article entitled "Pulmonary Complications and Water Retention in Prolonged Mechanical Ventilation" Sladen et al.1 mention that many investigators have studied the effects of continuous positive-pressure or negative-pressure ventilation in man or in animals. They state that "Intermittent positive-pressure breathing [IPPR] in patients with respiratory failure is not the exact clinical counterpart to the experimental studies, but it seems probable that similar changes in secretion of antidiuretic hormone [ADH], with accompanying depression of renal hemodynamics, could account for the water retention, weight gain and dilutional hyponatremia seen in our patients."As I have pointed out earlier, . . .