[Usefulness of human atrial natriuretic peptide (hANP) on perioperative management for liver resection]

We investigated whether postoperative renal function was affected by a low central venous pressure (CVP) management induced by restricted fluid administration in order to reduce blood loss during liver resection. In addition, we examined whether the continuous low-dose infusion of human atrial natriuretic peptide (hANP) during operation improved perioperative hemodynamic status and postoperative renal function in surgical patients for hepatectomy who were managed to maintain CVP at a low level.

The 39 subjects underwent liver resection, and they were randomized to receive 0.025 microg x kg(-1) x min(-1) of hANP (n = 19) or placebo (saline, n = 20) infusion during surgery. Blood samples for measurement of serum concentrations of BUN and creatinine were taken before surgery, at admission to ICU and on postoperative day 1.

The mean volume of fluid infusion and urinary output were significantly higher in the hANP group, but there were no differences in the values of BUN and creatinine during perioperative period between the two groups.

A restricted fluid infusion strategy during liver resection did not affect postoperative renal function and the continuous infusion of hANP showed no improvement effects on BUN and creatinine concentrations.