Brain-type natriuretic peptide and right ventricular end-diastolic volume index measurements are imprecise estimates of circulating blood volume in critically ill subjects

Takahashi, Edwin A.; Moran, Sharon; Hayashi, Michael; Inouye, David; Takanishi, Danny; Yu, Mihae

doi:10.1097/ta.0b013e3182a85f3a

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…BNP didn't appear to be a reliable marker of uid status in septic patients. Similar studies had also shown that BNP was not signi cantly associated with uid volume and uid responsiveness in patients with sepsis 24,25 . cTnI is the most sensitive and speci c marker of myocardial injury.…”

Section: Discussionmentioning

confidence: 68%

Brain natriuretic peptide (BNP) and cardiac troponin I(cTnI) for prediction of the prognosis in cancer patients with sepsis

Yang

Wang²,

Leng

et al. 2021

Preprint

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Background This study aimed to study the value of brain natriuretic peptide (BNP) and cardiac troponin I(cTnI) for predicting the prognosis in cancer patients with sepsis. Methods A cohort of 233 cancer patients with sepsis admitted to our ICU from January 2017 to October 2020 was included in this retrospective study. BNP and cTnI on the first day (d1) and the third day(d3) after entering ICU, blood lactate (Lac), procalcitonin (PCT), Leucocyte, Sequential Organ failure assessment (SOFA) scores, the incidence of septic shock, acute kidney injury(AKI), acute respiratory failure (ARF) requiring mechanical ventilation(MV) and sepsis-induced myocardial dysfunction(SIMD) within 24 hours of entering ICU, fluid balance in 24hr and 72hr of entering ICU, time of MV, length of stay in ICU ,emergency surgery were collected. According to the 28-day mortality, these patients were divided into the survival group (190 cases) and the death group (43 cases). All the above variables were compared. Results The multiple COX regression analysis of these variables indicated that BNP on d1 and d3, SOFA scores ,72hr fluid balance were independent predictors of the mortality in these patients (P < 0.05); The area under the ROC curve was 0.91 ± 0.01(P < 0.05) for BNP on d3. BNP on d3 at 681.5 pg/mL predicted the mortality with a sensitivity of 91.5% and a specificity of 88.7%. All patients were divided into two groups (BNP on d3 < 681.5 pg/ml or > 681.5 pg/ml), Kaplan-Meier analysis performed on the two groups showed a significant difference in the survival curve (P < 0.05) .There were also significant differences on the comorbidities including shock, AKI, ARF in both groups (P < 0.05). 126 out of 233 patients underwent random bedside echocardiography, and a total of 42 cases developed SIMD with an incidence rate of 33.3% (30.6% in the survival group and 40.9% in the death group). There was no significant difference in the incidence of SIMD between the survival group and the death group (P = 0.23). There was a significant difference between the non-SIMD and the SIMD group for BNP on d1 and d3(P < 0.05). Conclusions BNP was a great predictor for the prognosis of cancer patients with sepsis, while cTnI was not.

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Section: Discussionmentioning

confidence: 68%

Brain natriuretic peptide (BNP) and cardiac troponin I(cTnI) for prediction of the prognosis in cancer patients with sepsis

Yang

Wang²,

Leng

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…BNP didn’t seem to be a reliable marker of fluid status in septic patients. Similar studies had also shown that BNP was not closely associated with fluid volume and fluid responsiveness in patients with sepsis[ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 83%

Brain natriuretic peptide and cardiac troponin I for prediction of the prognosis in cancer patients with sepsis

et al. 2021

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Background This article aimed to study the value of brain natriuretic peptide (BNP) and cardiac troponin I(cTnI) for predicting the prognosis in cancer patients with sepsis. Methods A cohort of 233 cancer patients with sepsis admitted to our ICU from January 2017 to October 2020 was included in this retrospective study. The data of BNP and cTnI on the first day (d1) and the third day(d3) after entering ICU, blood lactate (Lac), procalcitonin (PCT), Leucocyte and Sequential Organ failure assessment (SOFA) scores within 24 hr of entering ICU, the incidence of septic shock, acute kidney injury(AKI), acute respiratory failure (ARF) or sepsis-induced myocardial dysfunction(SIMD) in ICU, fluid balance in 24 hr and 72 hr after entering ICU, time of mechanical ventilation(MV), length of stay, emergency surgery were collected. According to 28-day mortality, patients were divided into survival group (190 cases) and death group (43 cases). All the above variables were compared. Results BNP was an independent predictor for the mortality in these patients (P < 0.05).While cTnI was not. BNP on d3 in 681.5 pg/ml predicted the mortality with a sensitivity of 91.5 % and a specificity of 88.7 %. All patients were divided into the new two groups following the cutoff value of BNP on d3(681.5pg/ml), and the survival curve showed a significant difference with Kaplan-Meier analysis (P < 0.05). BNP had statistical differences between four groups based on the comorbidities(septic shock, AKI, ARF or SIMD), but cTnI was not. Conclusions BNP was a great predictor for the prognosis of cancer patients with sepsis, while cTnI was not.

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“…Elevated levels of BNP and NT‐proBNP have been associated with reduced ejection fraction and stroke volume, global tissue hypoxia, reduced cardiac index, sepsis induced myocardial dysfunction, prior cardiac dysfunction, diastolic left ventricular size and systolic as well as diastolic dysfunction . On the contrary, BNP has been found to be a poor predictor of volume status in critically ill patients, including patients with septic shock . Nevertheless, BNP levels have also been found to be elevated in patients with severe sepsis and septic shock in patients with normal left ventricular ejection fraction …”

Section: Resultsmentioning

confidence: 99%

“…29,32,36 On the contrary, BNP has been found to be a poor predictor of volume status in critically ill patients, including patients with septic shock. 53 Nevertheless, BNP levels have also been found to be elevated in patients with severe sepsis and septic shock in patients with normal left ventricular ejection fraction. 38 In addition, brain natriuretic peptides have been found to be significantly more increased in septic shock than in cardiogenic shock and have been used to distinguish between the two conditions.…”

Section: Brain Natriuretic Peptides Levels In Respect To Cardiac Fumentioning

confidence: 99%

The utility of brain natriuretic peptides in septic shock as markers for mortality and cardiac dysfunction: A systematic review

et al. 2019

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Objective To conduct a systematic review evaluating the utility of brain natriuretic peptide (BNP) and N‐terminal proBNP (NT‐proBNP) as biomarkers in adult patients with septic shock. Materials and Methods Pubmed/Medline databases were searched from inception to November 2018 using the search terms: (septic[Title/Abstract] AND shock[Title/Abstract]) AND bnp[Title/Abstract]) and (septic[Title/Abstract]) AND shock[Title/Abstract]) AND natriuretic[Title/Abstract]). No restriction was applied regarding date of publication. Comparative observational studies evaluating BNP and NT‐proBNP in patients with septic shock aged ≥18 years were eligible for inclusion. Bibliographies from the extracted articles were also reviewed to identify additional relevant publications. Results In total, 46 studies met all eligibility criteria and were included. A strong body of literature has demonstrated that in patients with septic shock, increased values of BNP and NT‐proBNP are associated with increased mortality. An increase from baseline BNP values has also been associated with increased mortality, whereas decreases from baseline values are not related to worse outcome. Brain natriuretic peptides have also been associated with cardiac dysfunction in patients with sepsis. Moreover, BNP values have been found to be significantly elevated in septic shock, regardless of cardiac dysfunction, and have been used to distinguish between septic and cardiogenic shock. Furthermore, BNP and NT‐proBNP are significantly increased in patients with septic shock, compared to patients with sepsis and severe sepsis. Conclusions BNP and NT‐proBNP appear to be reliable predictors of outcome in septic shock.

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Brain-type natriuretic peptide and right ventricular end-diastolic volume index measurements are imprecise estimates of circulating blood volume in critically ill subjects

Abstract: Diagnostic study, level III.

Cited by 8 publications

References 30 publications

Brain natriuretic peptide (BNP) and cardiac troponin I(cTnI) for prediction of the prognosis in cancer patients with sepsis

Brain natriuretic peptide (BNP) and cardiac troponin I(cTnI) for prediction of the prognosis in cancer patients with sepsis

Brain natriuretic peptide and cardiac troponin I for prediction of the prognosis in cancer patients with sepsis

The utility of brain natriuretic peptides in septic shock as markers for mortality and cardiac dysfunction: A systematic review

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