Influência da pressão expiratória final positiva (PEEP) e da função renal sobre o nível de peptídeo natriurético tipo B em pacientes com sepse grave e choque séptico

Issa, Victor Sarli; Taniguchi, Leandro Utino; Park, Marcelo; Cruz, Luiz Monteiro; Bocchi, Edimar Alcides; Velasco, Irineu Tadeu; Soriano, Francisco Garcia

doi:10.1590/s0066-782x2008001400008

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…However, BNP levels are independent of cardiac function and cardiovascular factors [28]. BNP release can be stimulated by various factors, including inflammatory cytokines [29] and renal impairment [30]. All of our subjects had a clear diagnosis of T2DM and those with diabetic complications that could affect the metabolism of BNP were excluded or limited.…”

Section: Discussionmentioning

confidence: 99%

Levels of brain natriuretic peptide are associated with peripheral arterial disease in subjects with type-2 diabetes mellitus

Chen

et al. 2014

BMC Endocr Disord

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BackgroundThe effects of brain natriuretic peptide (BNP) on the risk of cardiovascular disease and atherosclerosis have been studied. However, little information is available regarding peripheral arterial disease (PAD), particularly among subjects with type-2 diabetes mellitus (T2DM). The aim of our study was to assess the potential relationship between BNP levels and PAD among T2DM patients.MethodsThe study cohort was 507 T2DM outpatients in which BNP levels were measured. Cross-sectional associations between BNP levels (in tertiles) and PAD were examined.ResultsCompared withT2DM patients without PAD, BNP levels were markedly higher in patients with PAD (p = 0.001). Correlation analyses showed that the BNP level was negatively correlated with the ankle–brachial index (r = −0.453, p = 0.033). At a cutoff value of 78.2 pg/ml, the BNP level showed a sensitivity of 71.9%, a specificity of 68.1%, and a positive predictive value of 84.3% for a diagnosis of PAD. The area under the receiver-operating characteristic curve increased significantly if BNP levels were incorporated into a predictive model of the potential risk factors for PAD (0.85 vs 0.81, p = 0.029).ConclusionsBNP is a potential and promising biomarker for PAD screening in T2DM patients.

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Section: Discussionmentioning

confidence: 99%

Levels of brain natriuretic peptide are associated with peripheral arterial disease in subjects with type-2 diabetes mellitus

Chen

et al. 2014

BMC Endocr Disord

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“…Nevertheless, in fluid non-responders, acute ventricular stretching can result in further BNP release. In another study by Issa et al .,[19] they report on an inverse association between positive end-expiratory pressure and BNP levels in patients with severe sepsis and septic shock. BNP and creatinine levels should be taken into consideration when analyzing BNP levels in this setting.…”

Section: Discussionmentioning

confidence: 99%

Dynamics of brain natriuretic peptide in critically ill patients with severe sepsis and septic shock

et al. 2013

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Purpose:Changes of B-type natriuretic peptide (BNP) in sepsis and its utility in predicting intensive care unit outcomes remains a conflicting issue. To investigate the changes in plasma levels of BNP in patients with severe sepsis/septic shock and to study the association of BNP levels with the severity of the disease and prognosis of those patients.Methods:Thirty patients with severe sepsis or septic shock were enrolled in our study. BNP measurements and echocardiography were carried out on admission and on 4th and 7th days. Blood concentrations of BNP were measured by commercially available assays (Abbott methods). In-hospital mortality and length of stay were recorded multivariate analyses adjusted for acute physiology and chronic health evaluation score II (APACHE II score) was used for mortality prediction.Results:Twenty patients admitted with the diagnosis of severe sepsis and 10 patients with septic shock. The in-hospital mortality was 23.3% (7 patients). Admission BNP was significantly higher in the non-survivors 1123±236.08 versus 592.7±347.1 (P<0.001). By doing multivariate logestic regression, the predicatable variables for mortality was APACHE II score, BNP, and then EF.Conclusion:BNP concentrations were increased in patients with severe sepsis or septic shock and poor outcome was associated with high BNP levels; thus, it may serve as a useful laboratory marker to predict survival in these patients.

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Natriuretic Peptides to Predict Short-Term Mortality in Patients With Sepsis: A Systematic Review and Meta-analysis

Vallabhajosyula

Wang

Murad

et al. 2020

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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Data are conflicting regarding the optimal cutoffs of B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) to predict short-term mortality in patients with sepsis. We conducted a comprehensive search of several databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus) for English-language reports of studies evaluating adult patients with sepsis, severe sepsis, and septic shock with BNP/NT-proBNP levels and short-term mortality (intensive care unit, in-hospital, 28-day, or 30-day) published from January 1, 2000, to September 5, 2017. The average values in survivors and nonsurvivors were used to estimate the receiver operating characteristic curve (ROC) using a parametric regression model. Thirty-five observational studies (3508 patients) were included (median age, 51-75 years; 12%-74% males; cumulative mortality, 34.2%). A BNP of 622 pg/mL had the greatest discrimination for mortality (sensitivity, 0.695 [95% CI, 0.659-0.729]; specificity, 0.907 [95% CI, 0.810-1.003]; area under the ROC, 0.766 [95% CI, 0.734-0.797]). An NT-proBNP of 4000 pg/mL had the greatest discrimination for mortality (sensitivity, 0.728 [95% CI, 0.703-0.753]; specificity, 0.789 [95% CI, 0.710-0.867]; area under the ROC, 0.787 [95% CI, 0.766-0.809]). In prespecified subgroup analyses, identified BNP/NT-proBNP cutoffs had higher discrimination if specimens were obtained 24 hours or less after admission, in patients with severe sepsis/ septic shock, in patients enrolled after 2010, and in studies performed in the United States and Europe. There was inconsistent adjustment for renal function. In this hypothesis-generating analysis, BNP and NT-proBNP cutoffs of 622 pg/mL and 4000 pg/mL optimally predicted short-term mortality in patients with sepsis. The applicability of these results is limited by the heterogeneity of included patient populations.

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Influência da pressão expiratória final positiva (PEEP) e da função renal sobre o nível de peptídeo natriurético tipo B em pacientes com sepse grave e choque séptico

Abstract: SummaryBackground: Myocardial dysfunction is a complication associated with a poor prognosis in septic patients. A biomarker of cardiac function providing prognostic information is of paramount interest.

Cited by 4 publications

References 33 publications

Levels of brain natriuretic peptide are associated with peripheral arterial disease in subjects with type-2 diabetes mellitus

Levels of brain natriuretic peptide are associated with peripheral arterial disease in subjects with type-2 diabetes mellitus

Dynamics of brain natriuretic peptide in critically ill patients with severe sepsis and septic shock

Natriuretic Peptides to Predict Short-Term Mortality in Patients With Sepsis: A Systematic Review and Meta-analysis

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