The Role of ProBNP on Prognosis in Scorpion Stings

Abstract

Introduction-Scorpion stings are a major health problem with potentially fatal consequences. Children under the age of 10 y especially face a great risk. Predicting the prognosis is important in reducing mortality and morbidity because it enables the use of early treatment options. In this study, we examine the relationship between proBNP and prognosis in scorpion stings.Methods-This is a retrospective analysis of patients aged ≤18 y who were admitted to the child emergency service with a scorpion sting. We examined the demographical data, clinical findings, laboratory records, treatments, and results of the patients. We classified stage 1 and stage 2 scorpion envenomation as group 1 (mild-moderate) and stage 3 and 4 as group 2 (severe). A t test was used for normally distributed data, and the Mann-Whitney U test was used for nonnormally distributed data. The correlation analysis was done using the Spearman test.Results-There were 32 (74%) patients in the mild-moderate group and 11 (26%) in the severe group. ProBNP 1 was significantly higher in the severe group at admission (P=0.016). There was no difference between the troponin I values (P=0.051). ProBNP 2 (12th hour) and proBNP 3 (24th hour) were higher in the severe group (P=0.001 and P=0.032, respectively). There was a negative correlation between proBNP and echocardiographic findings involving ejection fraction and shortening fraction (R=-0.703, P=0.002).Conclusions-In our study, the first proBNP values were significantly higher in the severe group. This suggests that proBNP may be beneficial in predicting prognosis.

Snakebites in Pediatric Patients in Kahramanmaraş: Is Pro-brain Natriuretic Peptide a Prognostic Biomarker for Snakebites?

“…It has been reported that high BNP is associated with an increased risk of death in patients with acute respiratory distress syndrome (ARDS) [ 24 ]. Güllü et al studied cases of envenomation due to scorpion bites and showed proBNP to have a good predictive value for a poor outcome [ 7 ]. In this study, we determined a cutoff point for serum proBNP levels at 24 hours after snakebite to detect patients who can develop serious complications due to snakebites (sensitivity 83.3%, specificity 100%, p=0.011).…”

“…However, we could not find any study evaluating proBNP in snakebites. In addition, one study emphasized that proBNP has predictive value for morbidity in scorpion envenomation [ 7 ]. Considering this information, we think proBNP can be used as a prognostic marker in snakebites.…”

The effect of full blood count and cardiac biomarkers on prognosis in carbon monoxide poisoning in children

“…In another study conducted in adult patients with CO poisoning, NT-proBNP > 100 pg/mL at admission was found to be a significant marker in predicting left ventricular dysfunction [ 28 ]. In our previous studies, we reported the prognostic value of proBNP in various poisonings such as snake bites and scorpion bites [ 29 , 30 ]. We also showed that it was predictive of cardiac involvement in children with COVID-19 at the time of admission [ 31 ].…”

French Scorpionism (Mainland and Oversea Territories): Narrative Review of Scorpion Species, Scorpion Venom, and Envenoming Management

“…Envenomation may be responsible for a muscarinic syndrome characterized by bronchospasms with coughing and wheezing. The plasma levels of lactate, troponin, myoglobin, and brain natriuretic peptides (BNPs) are elevated in response to envenomation [ 45 , 104 , 105 ]. An electrocardiogram may reveal an isolated prolongation of the QT interval, signs of hypokalemia, or more rarely, hyperkalemia [ 106 ].…”

“…The symptoms of each class are fully described in Table 2 . Hyperleukocytosis, elevated plasma transaminases, lactates, BNP, reduced alkaline reserve, and kalemia are associated with severe envenomation (class III) and a risk of death [ 45 , 104 , 105 , 114 ]. The classification of Khattabi et al does not take the results of complementary examinations (biological, functional, and radiographic) into consideration.…”