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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Open Access 01-12-2012 | Original research

Prognostic value of B-type natriuretic peptide (BNP) and its potential role in guiding fluid therapy in critically ill septic patients

Authors: Zhongheng Zhang, Zhengguang Zhang, Yadong Xue, Xiao Xu, Hongying Ni

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2012

Abstract

Background and objectives

The prognostic role of B-type natriuretic peptide (BNP) in septic patients is controversial. The study aimed to investigate the prognostic value of BNP in critically ill septic patients. Furthermore, because BNP is primarily released from ventricles in response to myocardial stretch, the second aim of the study was to test whether the change in BNP was correlated to the amount of fluid balance.

Methods

This was a prospective observational study conducted in a tertiary 18-bed ICU. Patients fulfilled criteria of sepsis were enrolled. Exclusion criteria included renal dysfunction on ICU entry, age < 18 or >80 years old. BNP was measured on entry (BNP0) and day 3 (BNP1) and daily fluid balance over the three days were recorded. Diagnostic performances of BNP0 and ΔBNP (BNP1-BNP0) were analyzed. The correlation between fluid balance and ΔBNP were tested using Spearman’s correlation test.

Results

A total of 67 subjects were eligible for the study during study period. BNP0 was significantly higher in non-survivors than in survivors (738 vs 550 pg/ml, p < 0.01). The area under curves (AUCs) of BNP0 in predicting mortality, duration of mechanical ventilation (MV) > 7 d, length of stay in ICU (LOS_ICU) > 7 d and hospital (LOS_hospital) > 12 d were 0.71, 0.79, 0.66 and 0.71, respectively. The AUCs of ΔBNP in predicting duration of MV > 7 d, LOS_ICU > 7 d and LOS_hospital > 12 d were 0.80, 0.84 and 0.85, respectively. The amount of fluid balance was correlated to ΔBNP (Spearman’s rho = 0.63, p < 0.01), and the correlation remained statistically significant in multivariate model.

Conclusions

BNP measured on ICU entry is associated with mortality, duration of MV, LOS_ICU and LOS_hospital. ΔBNP is able to predict the LOS_ICU and LOS_hospital with satisfactory sensitivity and specificity. ΔBNP is closely correlated to the amount of fluid balance during resuscitation period. However, this could only be considered as a hypothesis-generating pilot study due to its small sample size and the observational nature.

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Title: Prognostic value of B-type natriuretic peptide (BNP) and its potential role in guiding fluid therapy in critically ill septic patients
Authors: Zhongheng Zhang
Zhengguang Zhang
Yadong Xue
Xiao Xu
Hongying Ni
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine / Issue 1/2012
Electronic ISSN: 1757-7241
DOI: https://doi.org/10.1186/1757-7241-20-86

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prognostic value of B-type natriuretic peptide (BNP) and its potential role in guiding fluid therapy in critically ill septic patients

Abstract

Background and objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and objectives

Methods

Results

Conclusions

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