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Intensive Care Medicine

Published in:

01-11-2008 | Original

Prognostic value of midregional pro-atrial natriuretic peptide in ventilator-associated pneumonia

Authors: Renato Seligman, Jana Papassotiriou, Nils G. Morgenthaler, Michael Meisner, Paulo J. Z. Teixeira

Published in: Intensive Care Medicine | Issue 11/2008

Abstract

Objective

This study aimed to investigate the correlation of midregional pro-atrial natriuretic peptide (MR-proANP) with severity of septic status in patients with ventilator-associated pneumonia (VAP) and the usefulness of MR-proANP for mortality prediction in VAP.

Design

Prospective observational cohort study.

Setting

University Hospital.

Patients

Seventy-one patients consecutively admitted to ICU who developed VAP. Patients were followed for 28 days after diagnosis, when they were considered survivors. There were no interventions.

Results

MR-proANP levels increased from sepsis to severe sepsis and septic shock on D0 and D4 of VAP (0.002 and 0.02 respectively). Median MR-proANP levels on day 0 and day 4 (pmol/L [interquartile range]) were 149.0 (79.8–480.0) and 249.0 (93.6–571.0) in septic patients, 438.5 (229.3–762.0) and 407.5 (197.8–738.0) in severe sepsis, 519.5 (369.5–1282.3) and 632.0 (476.0–1047.5) in septic shock. On day 0 and day 4, MR-proANP levels were significantly higher in non-survivors (525.0 [324.0–957.8] and 679.5 [435.0–879.5], respectively) than in survivors (235.0 [102.0–535.0] and 254.0 [110.0–571.0], respectively; P = 0.004). Univariate logistic regression model for mortality included age, gender, APACHE II score, creatinine, logarithmic transformed MR-proANP (LnMR-proANP). Mortality was directly related to LnMR-proANP on D0 and D4, with odds ratios (OR) of 2.06 (95% CI 1.21–3.51) and 2.63 (1.33–5.23), respectively. In multivariate logistic regression, only LnMR-proANP D0 with OR = 2.35 (1.05–5.26) and LnMR-proANP D4 with OR = 3.76 (1.39–10.18) remained significant.

Conclusions

Our data demonstrated that MR-proANP levels increase progressively with the severity of sepsis and are independent predictors of mortality in VAP.

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Title: Prognostic value of midregional pro-atrial natriuretic peptide in ventilator-associated pneumonia
Authors: Renato Seligman
Jana Papassotiriou
Nils G. Morgenthaler
Michael Meisner
Paulo J. Z. Teixeira
Publication date: 01-11-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 11/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1173-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Prognostic value of midregional pro-atrial natriuretic peptide in ventilator-associated pneumonia

Abstract

Objective

Design

Setting

Patients

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Results

Conclusions

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