Effects Of Extracorporeal Membrane Oxygenation On The Concentration Of ANP、BNP、NT-pro BNP And ET-1in Plasma Of Dogs

Objective:By surveying the dynamic changes of the concentration of atrial natriuretic peptide (ANP). brain natriuretic peptide (BNP). N terminal pro-brain natriuretic peptide (NT-pro BNP) and endothelin-1(ET-1) in the plasma of dogs, to find the useful indicators to monitor the change of myocardial function during ECMOMethods:Six healthy mongrel male dogs were selected, treated by V-A ECMO at the femoral artery and femoral vein. Before the ECMO operation, all the experimental dogs received same dose of sodium lactate ringer injection intravenous transfusions to pre-fill all connecting pipes. All dogs have the same type of membrane oxygenation and centrifugal pumps and under the same experimental environment. The plasma samples were collected at the30minutes before the ECMO operation and after ECMO starting lst hour,2nd hour.3rd hour.6th hour.24th hour and36th hour. The concentration of ANP. BNP. NT-pro BNP and ET-1in the plasma were measured by double antibody enzyme-linked sandwich assays(ABC-ELISA). in order to evaluate the dynamic changes of those selected blood factor. By the method of the self-control approach, all the experimental data obtained were analysed by statistical analysis software SPSS16.0. Results were expressed with F value and P value. P<0.05was considered statistically significant.Results:During ECMO process. the concentrations of plasma ANP. BNP. NT-proBNP and ET-1in the serum of the experimental dogs were significantly different in different time periods. Compared with the plasma level before starting ECMO operation, the concentration of BNP increased significantly at4th,5th,6th,24th time points after starting ECMO operation(p<0.05). then it decreased to the level before starting ECMO operation:the concentration of NT-pro BNP increased significantly at24th time point after starting ECMO operation(p<0.05). then it decreased again:the concentration of ANP increased significantly at lst hour after ECMO began(p<0.05). while that of24th hour increased again, but there was no statistical difference Cp>0.05):the concentration of ET-1decreased significantly at1st hour after starting ECMO operation(p<0.05). then the concentration of ET-1recovered to the level before starting ECMO operation. Meanwhile, after the Pearson correlation analysis, changes of the concentration of plasma BNP and NT-proBNP during the ECMO process has a significant positive correlation (correlation coefficient is0.684, P=0.00<0.01).Conclusions:At the time that two hours after starting ECMO operation, there was a significant difference of the concentration of ANP and ET-1compared to that before the ECMO operation, and later plasma ANP and ET-1gradually returned to normal levels;during the time period that24hours after starting ECMO operation.the concentration of BNP and NT-proBNP continued to increase. The significant difference of concentration of BNP and NT-proBNP between the two different peroids indicated the potential occurrence of myocardial dysfunction or heart failure. The short-term changes in the concentration of ANP and ET-1also suggest cardiac function obstacles. As can be seen, in terms of the degree of myocardial function in health, BNP and NT-proBNP had significantly better performance than ANP and ET-1. Therefore, the concentration of BNP, NT-pro BNP, ANP and ET-1in the plasma can be used to monitor the dynamic change of myocardial function during ECMO.