Science review Natriuretic peptides in critical illness 英文参考文献.docVIP

Critical Care October 2004 Vol 8 No 5 Witthaut Review Science review: Natriuretic peptides in critical illness Rochus Witthaut Medizinische Klinik III, Klinikum Kroellwitz, Martin-Luther-University Halle–Wittenberg, Halle/Saale, Germany Corresponding author: Rochus Witthaut, rochus.witthaut@medizin.uni-halle.de Published online: 17 June 2004 Critical Care 2004, 8:342-349 (DOI 10.1186/cc2890) This article is online at /content/8/5/342 ? 2004 BioMed Central Ltd Abstract The present review will cover the mechanisms of release and the potential pathophysiological role of different natriuretic peptides in critically ill patients. By focusing on the cardiovascular system, possible implications of natriuretic peptides for diagnosis and treatment will be presented. In critical illness such as sepsis, trauma or major surgery, systemic hypotension and an intrinsic myocardial dysfunction occur. Impairment of the cardiovascular system contributes to poor prognosis in severe human sepsis. Natriuretic peptides have emerged as valuable marker substances to detect left ventricular dysfunction in congestive heart failure of different origins. Increased plasma levels of circulating natriuretic peptides, atrial natriuretic peptide, N-terminal pro-atrial natriuretic peptide, brain natriuretic peptide and its N-terminal moiety N-terminal pro-brain natriuretic peptide have also been found in critically ill patients. All of these peptides have been reported to reflect left ventricular dysfunction in these patients. The increased wall stress of the cardiac atria and ventricles is followed by the release of these natriuretic peptides. Furthermore, the release of atrial natriuretic peptide and brain natriuretic peptide might be triggered by members of the IL-6-related family and endotoxin in the critically ill. Apart from the vasoactive actions of circulating natriuretic peptides and their broad effects on the renal sys