Behavior of B-type natriuretic peptide during mechanical ventilation and spontaneous breathing after extubation.

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Behavior of B-type natriuretic peptide during mechanical ventilation and spontaneous breathing after extubation.

Minerva Anestesiol. 2009 Apr;75(4):179-83

Authors: Principi T, Falzetti G, Elisei D, Donati A, Pelaia P

BACKGROUND: The behavior of B-type natriuretic peptide (BNP) is assessed during mechanical ventilation (MV) and spontaneous breathing after extubation in critical patients. METHODS: Thirty patients admitted in the Intensive Care Unit (ICU) were enrolled. BNP, fluid balance (FB), airway pressure (AP) and dobutamine infusion needing (DP) were registered in three stages: T0, admission to ICU; T1, before extubation; T2, 24 h after extubation. RESULTS: Patients with congestive heart failure (CHF) had BNP values higher than other patients. The value of BNP during MV was greater than normal in all patients. The cut-off to discriminate patients with heart failure during MV was 286 pgxmL(-1)(sensitivity: 86%; specificity: 90%). The increase of BNP during MV directly correlated with FB and inversely correlated with AP and DP. The plasmatic level of BNP remained higher than normal values 24 h after extubation. CONCLUSIONS: The underlying disease of an ICU patient seems to play a relevant role for BNP production and is probably linked to different aspects of therapeutic approach required by the patient. Our data suggest a cut-off value of BNP higher than the usual is necessary to discriminate mechanically-ventilated patients without CHF. This study should be repeated with an enlarged population.

PMID: 19078903 [PubMed - indexed for MEDLINE]

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