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Reduction of Free Water Clearance With Cephalic Venous Hypertension
Donald G. McQuarrie, MD;
Marc Mayberg;
Mark Ferguson;
Alan Shons, MD
Arch Surg. 1978;113(5):573-580.
Abstract
• A laboratory model was developed in the dog to quantitate the effects of cerebral venous hypertension on inappropriate antidiuretic hormone (ADH) secretion. When cerebral venous pressure was abruptly increased during continuous water loading, there was a sharp rise in urine osmolality within 30 minutes. Urine osmolality continued to increase during, and ten minutes after, the period of hypertension. On lowering cerebral venous pressure, the osmolality returned to baseline within 60 minutes. The effects could be extended for at least three hours and presumably longer. A 50% response threshold for this ADH effect occurred at a cerebral venous pressure between 18 and 19 cm of water. The effect correlated with plasma ADH levels. The study paralled documented clinical observations. The results are discussed in light of the recognition and management of surgical states where increased cerebral venous pressure might produce a severe antidiuretic effect.
(Arch Surg 113:573-580, 1978)
Author Affiliations
From the Departments of Surgery, Minneapolis Veterans Administration Hospital and University of Minnesota Hospitals, Minneapolis.
Footnotes
Accepted for publication Sept 6, 1977.
Read before the first annual meeting of the Association of Veterans Administration Surgeons, Nashville, Tenn, May 2-3, 1977.
Reprint request to Surgical Service, Veterans Administration Hospital, 54th St and 48th Ave S, Minneapolis, MN 55417 (Dr McQuarrie).
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