N-terminal pro-B-type natriuretic peptide levels increases after hyperbaric oxygen therapy in diabetic patients

Abstract

Purpose: Diabetic patients receive hyperbaric oxygen therapy for non-healing lower extremity ulcers. Exposure to hyperbaric hyperoxia during hyperbaric oxygen therapy may affect cardiovascular functions by different mechanisms. Patients may experience serious problems such as pulmonary edema and death during hyperbaric oxygen therapy. The effect of hyperbaric oxygen therapy on cardiovascular functions in diabetic patients is not well documented. N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been suggested as powerful biochemical marker of cardiac function. The aim of this study was to investigate the effect of hyperbaric oxygen therapy on NT-proBNP levels in diabetic patients. Methods: Twenty-five diabetic patients (19 male and 6 female, 64.7 ± 10.2 yr), who were planning to undergo hyperbaric oxygen therapy for non-healing lower extremity ulcers, were prospectively enrolled into the study. All patients were evaluated with echocardiography before the study. Heart rate and arterial blood pressure of patients were measured, and venous blood samples were drawn from each patient for NT-proBNP analysis before and immediately after the hyperbaric oxygen therapy. Results: NT-proBNP levels increased from 815 ± 1096 pg/ml to 915 ± 1191 pg/ml after HBO2 therapy (P < 0.05). Heart rate and arterial blood pressure did not change with HBO2 therapy (P > 0.05). Conclusion: Hyperbaric oxygen therapy induces considerable ventricular wall stress in diabetic patients. Care should be taken when a diabetic patient with cardiovascular disease is treated with hyperbaric oxygen therapy.

NT-proBNP in cardiopulmonary resuscitated patients treated with mild therapeutic hypothermia is not independently associated with mortality: a retrospective observational study

“…This is the opposite of one of the suggested biological functions of BNP, which is to facilitate hemoconcentration in order to increase the per volume oxygen carrying capacity of blood in response to hypoxia [ 18 ]. In contrast, the opposite of hypoxia, a higher than normal partial oxygen pressure, hyperoxia, may also cause elevation of NT-proBNP levels in-vivo [ 19 ]. Supplemental oxygen is often administered during cardiopulmonary resuscitation and a high PaO 2 is no rare phenomenon, especially in mechanically ventilated patients [ 20 - 22 ].…”

B-Type Natriuretic Peptide Predict Mortality in Diabetic Patients with Foot Ulcer

“…Very recently a number of studies have investigated the value of BNP in diabetes disease (20)(21)(22)(23)(24) but role of BNP in the prognosis of diabetic patients with foot ulcer has not been examined except after the use of hyperbaric oxygen therapy (25). This study has shown that patients with BNP > 100 pg/mL mg/dl have a higher risk of all-cause mortality in patients with foot ulcer.…”

N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Indicator for 30-Day Mortality Following Out-of-Hospital Cardiac Arrest: A prospective observational study.

“…These ndings are consistent with two previous studies [24,25], reporting a similar association between admission levels of NT-proBNP and outcome in resuscitated OHCA patients. There are several possible mechanisms for increased NT-proBNP/BNP secretion during cardiac arrest and CPR, including hypoxemia [30], ischemia [31], ischemia-reperfusion induced in ammation [32], therapeutic interventions with administration of uids [33] and vasopressors [34], and mechanical ventilation with supplementary oxygen administration [35]. Myhre et al 2016 [24] demonstrated an increase in NT-proBNP levels from admission up to 96 hours after hospitalization in OHCA-VT/VF patients.…”