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Prognostic values of B-type natriuretic peptide in severe sepsis and septic shock*

2007; Lippincott Williams & Wilkins; Volume: 35; Issue: 4 Linguagem: Inglês

10.1097/01.ccm.0000259469.24364.31

1530-0293

Anthony S. McLean, Stephen Huang, Stephanie Hyams, Genie Poh, Marek Nalos, Rahul Pandit, Martin Balík, Ben Tang, Ian Seppelt,

Hemodynamic Monitoring and Therapy

To investigate the changes in B-type natriuretic peptide concentrations in patients with severe sepsis and septic shock and to investigate the value of B-type natriuretic peptide in predicting intensive care unit outcomes.Prospective observational study.General intensive care unit.Forty patients with severe sepsis or septic shock.None.B-type natriuretic peptide measurements and echocardiography were carried out daily for 10 consecutive days. In-hospital mortality and length of stay were recorded. The admission B-type natriuretic peptide concentrations were generally increased (747 +/- 860 pg/mL). B-type natriuretic peptide levels were elevated in patients with normal left ventricular systolic function (568 +/- 811 pg/mL), with sepsis-related reversible cardiac dysfunction (630 +/- 726 pg/mL), and with chronic cardiac dysfunction (1311 +/- 1097 pg/mL). There were no significance changes in B-type natriuretic peptide levels over the 10-day period. The daily B-type natriuretic peptide concentrations for the first 3 days neither predicted in-hospital mortality nor correlated with length of intensive care unit or hospital stay.B-type natriuretic peptide concentrations were increased in patients with severe sepsis or septic shock regardless of the presence or absence of cardiac dysfunction. Neither the B-type natriuretic peptide levels for the first 3 days nor the daily changes in B-type natriuretic peptide provided prognostic value for in-hospital mortality and length of stay in this mixed group of patients, which included patients with chronic cardiac dysfunction.