Natriuretic peptide testing for the evaluation of critically ill patients with shock in the intensive care unit: a prospective cohort study
| العنوان: | Natriuretic peptide testing for the evaluation of critically ill patients with shock in the intensive care unit: a prospective cohort study |
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| المؤلفون: | Januzzi, James L, Morss, Alexander, Tung, Roderick, Pino, Richard, Fifer, Michael A, Thompson, B Taylor, Lee-Lewandrowski, Elizabeth |
| المصدر: | Critical Care |
| بيانات النشر: | BioMed Central, 2006. |
| سنة النشر: | 2006 |
| مصطلحات موضوعية: | Intensive Care Units, Risk Factors, Research, Natriuretic Peptide, Brain, Humans, Shock, cardiovascular diseases, Protein Precursors, Prognosis, Severity of Illness Index, hormones, hormone substitutes, and hormone antagonists, Biomarkers, Peptide Fragments |
| الوصف: | Introduction 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. Method 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. Results 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 higher than those in other log-quartiles (P < 0.001); NT-proBNP independently predicted ICU mortality (odds ratio 14.8, 95% confidence interval 1.8–125.2; P = 0.013), and was superior to Acute Physiology and Chronic Health Evaluation II score and brain natriuretic peptide in this regard. Conclusion Elevated levels of NT-proBNP do not necessarily correlate with high filling pressures among patients with ICU shock, but marked elevation in NT-proBNP is strongly associated with ICU death. Low NT-proBNP values in patients with ICU shock identifed those at lower risk for death, and may be useful in excluding the need for pulmonary artery catheter placement in such patients. |
| اللغة: | English |
| تدمد: | 1466-609X 1364-8535 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=pmid________::8e2d2809dde075060b7707d70070c77bTest http://europepmc.org/articles/PMC1550815Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.pmid..........8e2d2809dde075060b7707d70070c77b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1466609X 13648535 |
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