Association between elevated brain natriuretic peptide levels and weaning failure: A systematic review and meta‐analysis

Abstract

Objective: Cardiovascular dysfunction has been reported as an important mechanism of weaning failure, and recent data suggest that elevated brain natriuretic peptide (BNP) levels is associated with an increased risk of weaning failure. Therefore, we performed this meta-analysis to evaluate the correlation between elevated BNP levels and weaning failure in critically ill patients subject to mechanical ventilation.Methods: A systematic search in Cochrane Library, Embase, PubMed and Web of Science was performed up to September 25, 2019. Standard mean differences (SMD) and corresponding 95% confidence intervals (CIs) of the BNP levels were calculated for each study.Results: Nine studies with a total number of 589 were included in the final metaanalysis. The results showed that elevated BNP levels were significantly associated with the risk of weaning failure (SMD: 0.76, 95% CI: 0.47 to 1.05, P < .00001). The finding was consistent with the BNP measured before (SMD: 0.68, 95% CI: 0.26 to 1.11, P = .002) or at the end of spontaneous breathing trial (SBT) (SMD: 0.85, 95% CI: 0.52 to 1.18, P < .00001). Conclusions:This meta-analysis showed that increased plasma BNP concentration was associated with weaning failure in ICU patients.

Difficult Respiratory Weaning after Cardiac Surgery: A Narrative Review

“…Cardiac biomarkers may be a useful tool in the evaluation of patients before and during the weaning process. Two recent pooled analyses of studies on BNP and weaning confirmed that higher levels before SBT are predictive of weaning failure [ 41 , 42 ]. In their observational study, Farghaly and coworkers measured BNP before and after 2 h of SBT.…”