Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital

Effect of hypotensive hypovolemia and thoracic epidural anesthesia on plasma pro-atrial natriuretic peptide to indicate deviations in central blood volume in pigs: a blinded, randomized controlled trial

Research output: Contribution to journalJournal articleResearchpeer-review


  1. New lidocaine lozenge as topical anesthesia compared to lidocaine viscous oral solution before upper gastrointestinal endoscopy

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Fibrogenesis and inflammation contribute to the pathogenesis of cirrhotic cardiomyopathy

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Upgrading hypertension treatment

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Unexpected, isolated activated partial thromboplastin time prolongation: A practical mini-review

    Research output: Contribution to journalReviewResearchpeer-review

  4. Using computerized assessment in simulated colonoscopy: a validation study

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Purpose: Changes in plasma pro-atrial natriuretic peptide (proANP) may indicate deviations in the central blood volume (CBV). We evaluated the plasma proANP response to hypotensive hypovolemia under the influence of thoracic epidural anesthesia (TEA) in pigs. We hypothesized that plasma proANP would decrease in response to hypotensive hypovolemia and that TEA would aggravate the proANP response, reflecting a further decrease in CBV.

Design: Randomized, blinded, controlled trial.

Setting: A university-affiliated experimental facility.

Participants: Twenty pigs randomized to administration of saline (placebo) or bupivacaine with morphine (TEA) in the epidural space at Th8-Th10.

Interventions: Relative hypovolemia was established by an inflatable Foley catheter positioned in the inferior caval vein just below the heart (caval obstruction), and hemorrhage-induced hypovolemia was by withdrawal of blood from the femoral artery, both aiming at a mean arterial pressure (MAP) of 50-60 mmHg. Hemodynamic variables and plasma proANP were determined before and after the interventions.

Results: Caval obstruction and withdrawal of blood reduced MAP to 50-60 mmHg. Accordingly, cardiac output, central venous pressure, and mixed venous oxygen saturation decreased (p<0.05). Yet, plasma proANP was stable after both caval obstruction (TEA: 72 [63-78] to 80 pmol/L [72-85], p=0.09 and placebo: 64 [58-76] to 69 pmol/L [57-81], p=0.06) and withdrawal of blood (TEA: 74 [73-83] to 79 pmol/L [77-87], p=0.07 and placebo: 64 [56-77] to 67 pmol/L [58-78], p=0.15).

Conclusion: Plasma proANP was stable in response to relative and hemorrhage-induced hypovolemia to a MAP of 50-60 mmHg, and the response was independent of TEA. The findings suggest that alterations in plasma proANP do not follow deviations in CBV during hypotensive hypovolemia in pigs.

Original languageEnglish
JournalLocal and Regional Anesthesia
Pages (from-to)47-55
Number of pages9
Publication statusPublished - 2019

ID: 58062241