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Chappell, Daniel; Bruegger, Dirk; Potzel, Julia; Jacob, Matthias; Brettner, Florian; Vogeser, Michael; Conzen, Peter; Becker, Bernhard F.; Rehm, Markus (2014): Hypervolemia increases release of atrial natriuretic peptide and shedding of the endothelial glycocalyx. In: Critical Care 18:538


Acute normovolemic hemodilution (ANH) and volume loading (VL) are standard blood-sparing procedures. However, VL is associated with hypervolemia, which may cause tissue edema, cardiopulmonary complications and a prolonged hospital stay. The body reacts to hypervolemia with release of atrial natriuretic peptide (ANP) from the heart. ANP has been shown to deteriorate the endothelial glycocalyx, a vital part of the vascular permeability barrier. The aim of the present study was to evaluate and compare ANP release and damage to the glycocalyx during ANH and VL.