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Related Experiment Videos

Positive end expiratory pressure ventilation, renal function and renin.

S Kaukinen, R Eerola

    Annals of Clinical Research
    |April 1, 1979
    PubMed
    Summary

    Positive end expiratory pressure (PEEP) impairs kidney function in critically ill patients. This mechanical ventilation setting significantly reduces urine output and suggests impaired renal tubules ability to concentrate urine.

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    Area of Science:

    • Nephrology
    • Critical Care Medicine
    • Pulmonary Medicine

    Background:

    • Positive end expiratory pressure (PEEP) is a common mechanical ventilation strategy.
    • PEEP may affect renal function through hemodynamic changes or hormonal alterations.

    Purpose of the Study:

    • To investigate the impact of a standard 10 cm H2O PEEP on renal function and plasma renin activity.
    • To assess changes in urinary output, concentration, and creatinine clearance during PEEP.

    Main Methods:

    • Eleven intensive care patients receiving mechanical ventilation with 10 cm H2O PEEP for two hours were studied.
    • Patients received standard sedation and analgesia; diuretics were withheld.
    • Renal function parameters including urinary output, specific gravity, osmolality, sodium excretion, and creatinine clearance were measured.

    Main Results:

    • PEEP significantly decreased mean urinary output by 21%.
    • Urinary specific gravity and osmolality increased, indicating urine concentration.
    • Creatinine clearance showed a slight decrease, while free water clearance became less negative, suggesting reduced tubular concentrating ability.

    Conclusions:

    • 10 cm H2O PEEP impairs renal function in critically ill patients.
    • PEEP primarily induces water retention, potentially due to mechanisms other than increased aldosterone secretion.
    • The findings highlight the need for careful monitoring of renal function during PEEP therapy.

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