Antidiuretic hormone response in children with bronchopulmonary dysplasia during episodes of acute respiratory distress
M. Rao, N. Eid, L. Herrod, A. Parekh and P. Steiner
We investigated the antidiuretic hormone (ADH) response in 12 infants with
bronchopulmonary dysplasia during acute respiratory distress. All of the
infants had hypoxemia with air-trapping in the chest at the time of
admission to the hospital. None had documented infection. There was a
dramatic increase in the plasma levels of ADH during acute respiratory
distress, with a subsequent reduction of levels toward normal when the
respiratory distress decreased to the preadmission well state. Three of 12
infants manifested hyponatremia at 24 hours after admission, with two of
them exhibiting persistent hypertension for up to three days. The mechanism
for elevated ADH levels is air-trapping in the chest, causing pulmonary
hypovolemia and decreased left atrial filling and/or decreased transmural
pressure of the left atrium.
