B-type natriuretic peptide: Issues for the intensivist and pulmonologist

Phua, Jason; Lim, Tow Keang; Lee, Kang Hoe

doi:10.1097/01.ccm.0000178351.03327.9f

Cited by 85 publications

(69 citation statements)

References 150 publications

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“…19,20 More recently, it has been reported that the increase in these biomarkers may indicate the underlying subclinical predisposition to AF both in patients undergoing cardiac surgery 21 and in patients without a history of cardiac disease. 22 However, the capability of NT-proBNP to predict postoperative AF has never been evaluated prospectively; therefore, its clinical applicability remains unclear, as does its transferability to other clinical settings.…”

Section: Clinical Perspective P 1344mentioning

confidence: 99%

Increased Perioperative N-Terminal Pro-B-Type Natriuretic Peptide Levels Predict Atrial Fibrillation After Thoracic Surgery for Lung Cancer

et al. 2007

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Background-Postoperative atrial fibrillation (AF) is a complication of thoracic surgery for lung cancer, with a reported incidence that can run as high as 42%. Recently, it has been observed retrospectively that B-type natriuretic peptide predicts AF after cardiac surgery. We performed a prospective study to evaluate the role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) as a marker for risk stratification of postoperative AF in patients undergoing thoracic surgery for lung cancer. Methods and Results-We measured NT-proBNP levels in 400 patients (mean age, 62Ϯ10 years; 271 men) 24 hours before and 1 hour after surgery. The primary end point of the study was the incidence of postoperative AF. Overall, postoperative AF occurred in 72 patients (18%). Eighty-eight patients (22%) showed an elevated perioperative NT-proBNP value. When patients with either preoperatively or postoperatively elevated NT-proBNP were pooled, a greater incidence of AF was observed compared with patients with normal values (64% versus 5%; PϽ0.001). At multivariable analysis, adjusted for age, gender, major comorbidities, echocardiography parameters, pneumonectomy, and medications, both preoperative and postoperative NT-proBNP values were independent predictors of AF (relative risk, 27.9; 95% CI, 13.2 to 58.9; PϽ0.001 for preoperative NT-proBNP elevation; relative risk, 20.1; 95% CI, 5.8 to 69.4; PϽ0.001 for postoperative NT-proBNP elevation). Conclusions-Elevation of perioperative NT-proBNP is a strong independent predictor of postoperative AF in patients undergoing thoracic surgery for lung cancer. This finding should facilitate studies of therapies to reduce AF in selected high-risk patients.

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Section: Clinical Perspective P 1344mentioning

confidence: 99%

Increased Perioperative N-Terminal Pro-B-Type Natriuretic Peptide Levels Predict Atrial Fibrillation After Thoracic Surgery for Lung Cancer

et al. 2007

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“…However, the present data should be sufficient to draw conclusions that could potentially guide clinical practice. Since the plasma BNP level can also be affected by multiple disorders (including cardiac diseases, shock, pulmonary hypertension, acute pulmonary embolism, chronic obstructive pulmonary disease and renal failure), 24 caution should be taken when using BNP in the evaluation of patients with ALI/ARDS in combination with such conditions.…”

Section: Discussionmentioning

confidence: 99%

Assessment of acute lung injury/acute respiratory distress syndrome using B-type brain natriuretic peptide

Sun

Gao

et al. 2015

J Int Med Res

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Objectives: To investigate the clinical value of B-type natriuretic peptide (BNP) in the assessment of severity and prognosis in acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Methods: Plasma BNP level, arterial blood gases, serum C-reactive protein level, alveolar-arterial oxygen tension difference and oxygenation index were measured in patients with and without ALI/ ARDS within 24 h of admission to an intensive care unit. Patients with ALI/ARDS were divided into mild, moderate or severe groups according to the degree of hypoxaemia. Survival >28 days was recorded.Results: A total of 59 patients with ALI/ARDS and 14 patients without ALI/ARDS were included in the study. Of the patients with ALI/ARDS, 18 had mild hypoxaemia, 20 had moderate hypoxaemia and 21 had severe hypoxaemia. The mean AE SD BNP level was significantly higher in all three ALI/ ARDS groups (92.41 AE 28.19 pg/ml, 170.64 AE 57.34 pg/ml and 239.06 AE 59.62 pg/ml, respectively, in the mild, moderate and severe groups) than in the non-ALI/ARDS group (47.27 AE 19.63 pg/ml); the increase in BNP level with increasing severity was also statistically significant. When divided according to outcome, the BNP level in the death group (267.07 AE 45.06 pg/ml) was significantly higher than in the survival group (128.99 AE 45.42 pg/ml). Conclusions: The BNP level may be of value in evaluating severity and prognosis in patients with ALI/ARDS.

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“…or proinflammatory cytokines (18,19), volume resuscitation (20), and sepsis-associated acute lung injury or acute respiratory distress syndrome (21). Clinical severity scores such as acute physiology and chronic health evaluation (APACHE) II as well as sequential organ failure assessment (SOFA) scores have been validated as poor-outcome stratifications in patients with sepsis, but are unwieldy and tend to be used more for audit and research than clinical decision making.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Performance of Brain Natriuretic Peptide in Patients Suspected to Sepsis

Barati

Farnia

Eshaghi

et al. 2013

Arch Clin Infect Dis

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Background:One of the main components involving in the pathogenesis and prognosis of sepsis and septic shock is natriuretic peptide. Hemodynamic changes in sepsis or septic shock might explain increased plasma levels of these peptides circulations. Objectives: The present study aimed to assess the value of brain natriuretic peptide (BNP) in prediction of sepsis state and its related morbidity. We also attempted to determine the best cutoff point of BNP for diagnosis of sepsis state in those with critical illnesses, admitted to the hospital. Patients and Methods:In a cross-sectional study on critically ill patients referred to infections unit of Hazrat Rasoul Akram Hospital, the enrolled patients were assigned to one of the sepsis (n = 30) and nonsepsis (n = 30) groups, based on their results of blood culture and clinical manifestations. Plasma level of BNP was measured by immunoassay. Results: In-hospital mortality was only observed in one patient suffering from sepsis. Hospital length of stay (LOS) was significantly longer in the sepsis group compared with the nonsepsis one (17.47 ± 10.10 days versus 7.93 ± 2.92 days). The plasma BNP level, as a marker, was significantly higher in the sepsis group than the nonsepsis one (786.87 ± 164.11 ng/mL versus 154.57 ± 44.67 ng/mL, P = 0.039). The BNP level was significantly correlated with some baseline variables including respiratory rate (beta = 0.295, P = 0.022) and ESR measurement (beta = 0.296, P = 0.022), but not with other characteristics. Through multivariable linear regression analysis, having other patients' variables information including demographics and hemodynamic parameters, the BNP level was significantly higher in the sepsis group compared with the nonsepsis one (odds ratio = 1.008, P = 0.046). According to the receiver operating characteristic (ROC) curve analysis, BNP measurement had an acceptable value for discriminating sepsis and nonsepsis states (c = 0.734, 95% CI: 0.605-0.864, P = 0.002). The optimal cutoff point of BNP for discriminating sepsis and nonsepsis states was 170 ng/mL, yielding a sensitivity of 66.7% and a specificity of 60.0%. Conclusions: Elevated BNP level was associated with a significantly increased risk of sepsis state in critically ill patients.

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B-type natriuretic peptide: Issues for the intensivist and pulmonologist

Cited by 85 publications

References 150 publications

Increased Perioperative N-Terminal Pro-B-Type Natriuretic Peptide Levels Predict Atrial Fibrillation After Thoracic Surgery for Lung Cancer

Increased Perioperative N-Terminal Pro-B-Type Natriuretic Peptide Levels Predict Atrial Fibrillation After Thoracic Surgery for Lung Cancer

Assessment of acute lung injury/acute respiratory distress syndrome using B-type brain natriuretic peptide

Diagnostic Performance of Brain Natriuretic Peptide in Patients Suspected to Sepsis

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