The Role of Brain Natriuretic Peptide as a Prognostic Marker for Sepsis

Bhandari, Binita; Cunningham, Jessica

doi:10.7759/cureus.8954

Cited by 3 publications

(4 citation statements)

References 26 publications

(28 reference statements)

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“…Thus, in all groups of this study, a decrease in the serum NT-proBNP level was observed with age. This intriguing finding was not reported in many previous studies [ 6 , 7 , 13 , 14 , 20 ], but is consistent with the results of Keyzer et al and Pandompatam et al [ 13 , 19 ].…”

Section: Discussionsupporting

confidence: 93%

“…Substantial research has shown that serum NT-proBNP level is an independent predictor of mortality in patients with sepsis [ 5 , 7 , 10 , 13 , 14 , 20 ], and the established cut-off value for adult patients is 4000 pg/mL [ 9 – 14 ]. However, age-specific NT-proBNP cut-off values, as reported for the detection of heart failure [ 15 – 18 , 21 ], have yet to be reported for prediction of sepsis-related mortality in children.…”

Section: Discussionmentioning

confidence: 99%

“…In studies performed in the United States and Europe, patients with severe sepsis/septic shock was determined NT-proBNP cut-offs of 4000 pg/mL [sensitivity, 0.728 (95% CI were 0.703–0.753); specificity, 0.789 (95% CI were 0.710–0.867); AUC, 0.787 (95% CI were 0.766–0.809)] optimally predicted short-term mortality in adult patients with sepsis [ 9 ]. This cut-off value has been accepted and cited in several reports [ 10 – 14 ]. However, the serum NT-proBNP concentration closely correlates with age, especially in children [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Age-Stratified Cut-Off Values for Serum Levels of N-Terminal ProB-Type Natriuretic Peptide and Mortality from Sepsis in Children Under Age 18 Years: A Retrospective Study from a Single Center

et al. 2021

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Background The N-terminal fragment of proB-type natriuretic peptide (NT-proBNP) is an established predictive marker for sepsis-related mortality in adult. This retrospective study aimed to determine age-stratified cut-off values for serum levels of NT-proBNP and mortality from sepsis in children under 18 years. Material/Methods Patients were stratified by age as follows: <1 year, 1–3 years, 4–6 years, and 7–18 years (age groups). The control group consisted of age- and sex-matched healthy children. Serum NT-proBNP levels were detected by laboratory assays in the participants. The appropriate serum NT-proBNP cut-off values for predicting short-term mortality of the sepsis patients were calculated via receiver operating characteristic (ROC) curve analyses. Results Among 327 pediatric patients with sepsis, the serum NT-proBNP cut-off concentrations for predicting sepsis-related mortality in the <1 year, 1–3 years, 4–6 years, and 7–18 years age groups were 5000 ng/L, 4500 ng/L, 4100 ng/L, and 3800 ng/L, respectively ( P <0.001). The area under the ROC curve (AUC) values for these were 0.815, 0.812, 0.806 and 0.725, respectively ( P <0.001). Conclusions This retrospective study provided the age range-specific serum NT-proBNP cut-off concentrations for predicting short-term mortality in children. In children <1 year, 1–3 years, 4–6 years, and 7–18 years, age-stratified cut-off values that predicted sepsis-associated mortality were 5000 ng/L, 4500 ng/L, 4100 ng/L, and 3800 ng/L, respectively.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Age-Stratified Cut-Off Values for Serum Levels of N-Terminal ProB-Type Natriuretic Peptide and Mortality from Sepsis in Children Under Age 18 Years: A Retrospective Study from a Single Center

et al. 2021

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“…Neonatal sepsis can be serious, from subclinical infection to focal or systemic disease, with complications including pulmonary hypertension, heart failure, and other cardiovascular system symptoms, resulting in septic shock and even death of the newborn ( 52 ). BNP has been found to guide the diagnosis and prognosis of cardiac insufficiency in sepsis ( 53 , 54 ).…”

Section: Manuscript Formattingmentioning

confidence: 99%

Application of B-Type Natriuretic Peptide in Neonatal Diseases

et al. 2021

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Numerous congenital or secondary diseases, including, heart disease, respiratory disease, sepsis and many others, can lead to neonatal death. B-type natriuretic peptide (BNP) is a peptide hormone secreted by ventricular cells following an increase in ventricular wall tension. BNP functions to promote vasodilation, diuresis, and sodium release to regulate blood pressure. BNP is a sensitive index reflecting ventricular function, which may aid the diagnosis and monitoring of various neonatal diseases. In neonates, there is currently no consensus on a reference BNP level, as the plasma BNP concentration of healthy newborns varies with age, peaks in the first week after birth, and then gradually decreased to a stable level. In disease states, the correlation between the plasma BNP concentration and the results of echocardiography is good, which is of great significance in the screening, monitoring, and prognosis evaluation of neonatal cardiovascular diseases, including congenital heart disease, patent ductus arteriosus, etcetera. It also facilitates the judgment of the efficacy of treatment and perioperative management. Moreover, the monitoring of plasma BNP concentration provides guidance for the diagnosis, evaluation, and treatment selection of certain neonatal respiratory diseases and neonatal sepsis. This review summarizes the normal BNP values and discusses the application value of BNP in relation to physiological and pathological aspects in neonates.

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Combination of Prehospital NT-proBNP with qSOFA and NEWS to Predict Sepsis and Sepsis-Related Mortality

et al. 2022

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Background. The aim of this study was to assess the role of prehospital point-of-care N-terminal probrain natriuretic peptide to predict sepsis, septic shock, or in-hospital sepsis-related mortality. Methods. A prospective, emergency medical service-delivered, prognostic, cohort study of adults evacuated by ambulance and admitted to emergency department between January 2020 and May 2021. The discriminative power of the predictive variable was assessed through a prediction model trained using the derivation cohort and evaluated by the area under the curve of the receiver operating characteristic on the validation cohort. Results. A total of 1,360 patients were enrolled with medical disease in the study. The occurrence of sepsis, septic shock, and in-hospital sepsis-related mortality was 6.4% (67 cases), 4.2% (44 cases), and 6.1% (64 cases). Prehospital National Early Warning Score 2 had superior predictive validity than quick Sequential Organ Failure Assessment and N-terminal probrain natriuretic peptide for detecting sepsis and septic shock, but N-terminal probrain natriuretic peptide outperformed both scores in in-hospital sepsis-related mortality estimation. Application of N-terminal probrain natriuretic peptide to subgroups of the other two scores improved the identification of sepsis, septic shock, and sepsis-related mortality in the group of patients with low-risk scoring. Conclusions. The incorporation of N-terminal probrain natriuretic peptide in prehospital care combined with already existing scores could improve the identification of sepsis, septic shock, and sepsis-related mortality.

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The Role of Brain Natriuretic Peptide as a Prognostic Marker for Sepsis

Cited by 3 publications

References 26 publications

Age-Stratified Cut-Off Values for Serum Levels of N-Terminal ProB-Type Natriuretic Peptide and Mortality from Sepsis in Children Under Age 18 Years: A Retrospective Study from a Single Center

Age-Stratified Cut-Off Values for Serum Levels of N-Terminal ProB-Type Natriuretic Peptide and Mortality from Sepsis in Children Under Age 18 Years: A Retrospective Study from a Single Center

Application of B-Type Natriuretic Peptide in Neonatal Diseases

Combination of Prehospital NT-proBNP with qSOFA and NEWS to Predict Sepsis and Sepsis-Related Mortality

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