Abstract
B-type natriuretic peptide (BNP) regulates different physiological processes such as blood pressure, cardiac growth, and neural and skeletal development. Thus, the aim of this study w as to evaluate the effect of BNP in the treatment of acute asthma attacks. In this randomized clinical trial, patients with acute asthma attacks were enrolled. The patients were divided randomly into two groups. Patients in the interventional group received BNP via intravenous infusion. Two µg/kg of BNP was injected as a bolus in 60 seconds. Then, infusion of BNP immediately began and was given in 0.01, 0.02, and 0.03 µg/kg/min doses every 30 minutes for the first 1.5 hours. The patients in the control group received nebulized salbutamol. Afterwards, peak flow meter findings, hemodynamic parameters, and estimation of the clinical severity of asthma in both groups were checked every 30 minutes. In total, 40 patients were included in this study. The values of PEFR in the 60th and 90th minutes in the control group were lower than those in the interventional group. In the 60th minute, the mean of PEFR was 377.3 in the BNP group but 335.95 in the control group (P = 0.049). Moreover, this difference remained significant in the 90th minute (P = 0.021). However, forced expiratory volume in one second (FEV1) did not differ between the groups at any time (p > 0.05). Although a large experimental study is needed to verify our hypothesis, it seems that BNP might be a therapeutic option in asthma exacerbations, particularly in those with b2 agonist receptor polymorphism.
Highlights
B-type natriuretic peptide (BNP) regulates different physiological processes such as blood pressure, cardiac growth, and neural and skeletal development
Patients were excluded in the case that they were critically ill and required CPR, had a lack of favorable response to treatment and a deteriorating clinical condition requiring the use of other complementary therapies for the treatment of asthma, blood pressure < 100 mm Hg at admission, an allergic history to BNP, a history of smoking (10 packs per year), age either below 18 years or more than 55 years, and/or a dissatisfaction to continue participation in the study
Five patients were removed because they declined to participate and did not meet the inclusion criteria. 20 patients were placed into the interventional group and 20 were placed into the control group (Figure 1)
Summary
B-type natriuretic peptide (BNP) regulates different physiological processes such as blood pressure, cardiac growth, and neural and skeletal development. High dose b2 agonists, inhaled anticholinergics, and oral corticosteroids are often recommended to manage acute exacerbations [4,5,6,7,8]. These are not always effective [9] because of the resistance due to b2 adrenoreceptor gene polymorphism in 30% of patients [10, 11,12,13,14,15] which impacts the frequently delayed response to corticosteroids [16,17,18]. Finding other drugs which are effective in controlling signs and symptoms in this high-risk population is necessary
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