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Baroreflex function in a patient with Bartter’s syndrome

Abstract

There is little information regarding circulatory responses in Bartter’s syndrome, with the exception of marked resistance to vasopressors. We investigated baroreflex function in a 40-year-old woman with this syndrome. The patient showed oscillation of heart rate even with a small increase in blood pressure after administration ofvasopressor agents. Variations in heart rate and blood pressure were exaggerated during halothane, nitrous oxide and oxygen anaesthesia. Although the mechanism of the unstable baroreflex in this syndrome remains to be proved, the instability may be attributable to many factors such as prostaglandins, hypovolemia, hypokalemia, halothane, nitrous oxide and positive pressure ventilation.

Résumé

Il y a très peu d’information concernant les réponses vasculaires chez les patients atteints de syndrome de Bartter à l’exception de celle concernant une résistance marquée aux vasopresseurs. On a investigué la fonction des barorécepteurs chez une femme âgée de 40 ans atteinte de ce syndrome. La patiente a démontré une oscillation de la fréquence cardiaque même avec une augmentation minime de la tension artérielle suite à l’administration d’agents vasopresseurs. Les variations de la fréquence cardiaque et de la pression artérielle étaient exagérées lors de l’anesthésie à l’halothane, protoxide d’azote et oxygène. Même si le mécanisme de cette instabilité des barorécepteurs dans ce syndrome reste à prouver, cette instabilité peul-être attribuer à plusieurs facteurs dont les prostaglandines, l’hypovo-lémie, l’hypokalémie, l’halothane, le protoxide d’azote et la ventilation à pression positive.

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Correspondence to Toshiaki Nishikawa or Shuji Dohi.

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Nishikawa, T., Dohi, S. Baroreflex function in a patient with Bartter’s syndrome. Can Anaesth Soc J 32, 646–650 (1985). https://doi.org/10.1007/BF03011413

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Key words

  • complications: Bartter’s syndrome
  • hormone: prostaglandins
  • reflex: baroreflex
  • sympathetic nervous system: sympathomimetic agents