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Observational Study
. 2016 Jun;28(2):154-60.
doi: 10.5935/0103-507X.20160030.

Atrial natriuretic factor: is it responsible for hyponatremia and natriuresis in neurosurgery?

[Article in English, Portuguese]
Ana Paula Devite Cardoso Gasparotto  1 , Antonio Luis Eiras Falcão  1 , Carolina Kosour  1 , Sebastião Araújo  1 , Eliane Araújo Cintra  2 , Rosmari Aparecida Rosa Almeida de Oliveira  3 , Luiz Claudio Martins  1 , Desanka Dragosavac  1
Affiliations
Observational Study

Atrial natriuretic factor: is it responsible for hyponatremia and natriuresis in neurosurgery?

[Article in English, Portuguese]
Ana Paula Devite Cardoso Gasparotto et al. Rev Bras Ter Intensiva. 2016 Jun.

Abstract
in English, Portuguese

Objective: To evaluate the presence of hyponatremia and natriuresis and their association with atrial natriuretic factor in neurosurgery patients.

Methods: The study included 30 patients who had been submitted to intracranial tumor resection and cerebral aneurism clipping. Both plasma and urinary sodium and plasma atrial natriuretic factor were measured during the preoperative and postoperative time periods.

Results: Hyponatremia was present in 63.33% of the patients, particularly on the first postoperative day. Natriuresis was present in 93.33% of the patients, particularly on the second postoperative day. Plasma atrial natriuretic factor was increased in 92.60% of the patients in at least one of the postoperative days; however, there was no statistically significant association between the atrial natriuretic factor and plasma sodium and between the atrial natriuretic factor and urinary sodium.

Conclusion: Hyponatremia and natriuresis were present in most patients after neurosurgery; however, the atrial natriuretic factor cannot be considered to be directly responsible for these alterations in neurosurgery patients. Other natriuretic factors are likely to be involved.

Objetivo: Avaliar a presença de hiponatremia e natriurese, bem como suas associações com o fator natriurético atrial em pacientes de neurocirurgia.

Métodos: Foram incluídos 30 pacientes submetidos à ressecção de tumor intracraniano e à clipagem de aneurisma cerebral. Os níveis plasmáticos e urinários de fator natriurético atrial foram medidos durante os períodos pré e pós-operatório.

Resultados: Hiponatremia esteve presente em 63,33% dos pacientes, particularmente no primeiro dia pós-operatório. Observou-se natriurese em 93,33% dos pacientes, principalmente no segundo dia pós-operatório. Os níveis plasmáticos de fator natriurético atrial estavam aumentados em 92,60% dos pacientes em pelo menos um dos dias pós-operatórios, mas não houve associação estatisticamente significante entre fator natriurético atrial e sódio plasmático, e entre fator natriurético atrial e sódio urinário.

Conclusão: Após neurocirurgia, na maior parte dos pacientes, estiveram presentes hiponatremia e natriurese; contudo, o fator natriurético atrial não pôde ser considerado diretamente responsável por tais alterações nos pacientes neurocirúrgicos. Provavelmente, há o envolvimento de outros fatores natriuréticos.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
The average and standard deviation of plasma sodium (mEq/L), urinary sodium (mEq/12 hours) and plasma atrial natriuretic factor (pg/mL) in the pre- and postoperative time periods (D0 and D1 - 5). ANF - atrial natriuretic factor; Naplasm - plasma sodium; Nauri - urinary sodium.
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