A prospective study into the use of NT-proBNP measurements in critically ill patients

Abstract

Objective: B-type natriuretic peptide (BNP) has been shown to be a sensitive marker of cardiac dysfunction and to increase in patients with septic shock. This study seeks to confirm these findings in a mixed group of critically ill patients. Design and setting: Prospective observational study in a general intensive care unit (ITU) of a university hospital. Patients and participants: Ninety-three consecutive admissions to the general ITU.Interventions: Measurement of NT-proBNP on admission and then daily thereafter. Collection of clinical and demographical data in relation to NT-proBNP over a period of 5 days and outcome data at 28 days and hospital discharge. Measurements and results: NT-proBNP levels were raised for the whole population at each time point. NT-proBNP levels were higher in non-survivors than in survivors from ITU (p 0/0.02), at 28 days (p 0/0.02) or hospital discharge (p 0/0.0004). NTproBNP was raised in patients with sepsis (11 688 (6140 Á/20 434) vs. 767 (472 Á/2267) ng/L, p 0/B/0.0001), cardiac dysfunction (7336 (3383 Á/14 906) vs. 757 (428 Á/1819) ng/L, p 0/ B/0.0001), requirement for vasoactive therapy (7151 (1089 Á/14 318) vs. 1257 (721 Á/3127) ng/L, p0/0.01) and renal support (12 128 (2693 Á/25 831) vs. 1687 (752 Á/3291) ng/L, p 0/ B/0.0001). Multiple regression analysis demonstrated that independent predictors of raised NT-proBNP levels were the diagnosis of sepsis (p B/0.0001) or ongoing cardiac dysfunction (p 0/0.006).Conclusions: NT-proBNP levels are raised in critically ill patients. The cause of these increases relates to either sepsis or cardiac dysfunction.