Article ID Journal Published Year Pages File Type
2927168 IJC Metabolic & Endocrine 2016 6 Pages PDF
Abstract

BackgroundThe cardiac correlates, if any, of N-terminal probrain natriuretic peptide (NT-proBNP) levels in septic and non-septic shock patients remain controversial.MethodsIn the 38 septic and 22 non-septic shock patients in the transpulmonary thermodilution arm of a previous 2-center randomized controlled trial comparing pulmonary artery catheterization with transpulmonary thermodilution, serial (daily for 3 days) and paired measurements (n = 145) were obtained of NT-proBNP and transpulmonary dilution variables as global ejection fraction (GEF), left ventricular preload-recruitable stroke work (PRSW) and diastolic compliance.ResultsElevated NT-proBNP inversely related to low GEF and PRSW in pooled data (r = − 0.45, P < 0.001). The 72 h course of NT-proBNP was inversely associated with PRSW, independent of age, gender, creatinine, norepinephrine treatment and diastolic compliance, without differences between septic and non-septic shock. Over the 72 h study period, NT-proBNP levels were higher in 28 day non-survivors than survivors, independent of type of shock and disease severity.ConclusionsIn septic and non-septic shock, NT-proBNP elevations reflect systolic left ventricular dysfunction and are associated with a poor outcome. They may help recognition of cardiac dysfunction in shock and its management when invasive hemodynamic monitoring is not yet instituted.

Related Topics
Health Sciences Medicine and Dentistry Cardiology and Cardiovascular Medicine
Authors
, ,