Natriuretic peptide testing for the evaluation of critically ill patients with shock in the intensive care unit: a prospective cohort study

Critical Care : the Official Journal of the Critical Care Forum
James L JanuzziElizabeth Lee-Lewandrowski

Abstract

Amino-terminal pro-brain natriuretic peptide (NT-proBNP) is useful in evaluating heart failure, but its role in evaluating patients with shock in the intensive care unit (ICU) is not clear. Forty-nine consecutive patients in four different ICUs with shock of various types and with an indication for pulmonary artery catheter placement were evaluated. Analyses for NT-proBNP were performed on blood obtained at the time of catheter placement and results were correlated with pulmonary artery catheter findings. Logistic regression identified independent predictors of mortality. A wide range of NT-proBNP levels were observed (106 to >35,000 pg/ml). There was no difference in median NT-proBNP levels between patients with a cardiac and those with a noncardiac origin to their shock (3,046 pg/ml versus 2,959 pg/ml; P = 0.80), but an NT-proBNP value below 1,200 pg/ml had a negative predictive value of 92% for cardiogenic shock. NT-proBNP levels did not correlate with filling pressures or hemodynamics (findings not significant). NT-proBNP concentrations were higher in patients who died in the ICU (11,859 versus 2,534 pg/ml; P = 0.03), and the mortality rate of patients in the highest log-quartile of NT-proBNP (66.7%) was significantly highe...Continue Reading

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Citations

Apr 5, 2011·Critical Care : the Official Journal of the Critical Care Forum·Cathrin BalmelliChristian Mueller
Apr 6, 2006·Critical Care : the Official Journal of the Critical Care Forum·Ursula HoffmannMartina Brueckmann
Apr 20, 2007·Critical Care : the Official Journal of the Critical Care Forum·Antoine Roch
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