This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Intravascular volume and serum osmolality are tightly regulated by a balance of various neurohumoral mediators. In critical illness, these regulatory mediators may be modified by disease or treatment, either benefiting or harming the patient. Such regulatory mediators of intravascular volume and fluid balance include atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and vasopressin (also called anti-diuretic hormone-ADH). Although well studied in adult cardiac patients, these neurohormones have not been investigated in pediatric respiratory diseases such as bronchiolitis, a common cause of admission to the Pediatric Intensive Care Unit (PICU). Understanding the effects of pediatric respiratory diseases and treatment interventions on the concentrations of these neurohormonal regulators such as ANP and BNP is a crucial first step in formulating more effective fluid therapy. For example, some patients with bronchiolitis have elevated ADH levels. Increased ADH concentration predisposes to fluid retention and increases the risk of pulmonary edema. Since ANP and BNP antagonize the action of ADH, simultaneous measurement of all three hormones may help elucidate the mechanisms of fluid balance in bronchiolitis. The study hypothesis is that the plasma concentrations of ANP and BNP in infants and children with bronchiolitis are inversely associated with ADH concentration and lung hyperinflation. Furthermore, plasma concentrations of ANP and BNP in bronchiolitis are associated directly with increased oxygen requirement and positive fluid balance. The significance of this study to better understand the pathophysiology relationship between plasma concentrations of ADH, ANP and BNP in infants and small children with respiratory failure such as in moderate to severe bronchiolitis with an eventual goal of improving fluid/diuretic therapy and patient outcome. We plan to enroll 100 patients in this study. The population will be infants and children between 37 weeks and 2 years of age (corrected for gestational age). 50 control patients will be enrolled to record normal baseline plasma ANP, BNP, and ADH at time of admission in Shands Hospital surgical center at the University of Florida. In addition, 50 patients with bronchiolitis will be enrolled to collect ANP, BNP, and ADH plasma levels along with serum osmolality and urine osmolality for up to 5 consecutive days in Shands Children s Hospital.

National Institute of Health (NIH)
National Center for Research Resources (NCRR)
General Clinical Research Centers Program (M01)
Project #
Application #
Study Section
National Center for Research Resources Initial Review Group (RIRG)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Florida
Internal Medicine/Medicine
Schools of Medicine
United States
Zip Code
Mangal, Naveen; James, Margaret O; Stacpoole, Peter W et al. (2018) Model Informed Dose Optimization of Dichloroacetate for the Treatment of Congenital Lactic Acidosis in Children. J Clin Pharmacol 58:212-220
Boissoneault, Jeff; Letzen, Janelle; Lai, Song et al. (2016) Abnormal resting state functional connectivity in patients with chronic fatigue syndrome: an arterial spin-labeling fMRI study. Magn Reson Imaging 34:603-8
Shumyak, Stepan; Yang, Li-Jun; Han, Shuhong et al. (2016) ""Lupoid hepatitis"" in SLE patients and mice with experimental lupus. Clin Immunol 172:65-71
Hendeles, Leslie; Khan, Yasmeen R; Shuster, Jonathan J et al. (2015) Omalizumab therapy for asthma patients with poor adherence to inhaled corticosteroid therapy. Ann Allergy Asthma Immunol 114:58-62.e2
Price, Catherine C; Levy, Shellie-Anne; Tanner, Jared et al. (2015) Orthopedic Surgery and Post-Operative Cognitive Decline in Idiopathic Parkinson's Disease: Considerations from a Pilot Study. J Parkinsons Dis 5:893-905
Krueger, Charlene A; Cave, Emily C; Garvan, Cynthia (2015) Fetal response to live and recorded maternal speech. Biol Res Nurs 17:112-20
Jones, Jacob D; Marsiske, Michael; Okun, Michael S et al. (2015) Latent growth-curve analysis reveals that worsening Parkinson's disease quality of life is driven by depression. Neuropsychology 29:603-9
Morishita, Takashi; Foote, Kelly D; Archer, Derek B et al. (2015) Smile without euphoria induced by deep brain stimulation: a case report. Neurocase 21:674-8
Del-Aguila, J L; Cooper-DeHoff, R M; Chapman, A B et al. (2015) Transethnic meta-analysis suggests genetic variation in the HEME pathway influences potassium response in patients treated with hydrochlorothiazide. Pharmacogenomics J 15:153-7
Chapman, Arlene B; Cotsonis, George; Parekh, Vishal et al. (2014) Night blood pressure responses to atenolol and hydrochlorothiazide in black and white patients with essential hypertension. Am J Hypertens 27:546-54

Showing the most recent 10 out of 266 publications