Abstract
BackgroundThe primary objective of this study was to examine levels of B-type natriuretic peptide (BNP) in mechanically ventilated patients with acute lung injury and to test whether the level of BNP would be higher in patients with right ventricular dilatation and would predict mortality.MethodsThis was a prospective, observational cohort study of 42 patients conducted in the intensive care unit of a tertiary care university hospital. BNP was measured and transthoracic echocardiography was performed within 48 hours of the onset of acute lung injury. The left ventricular systolic and diastolic function, right ventricular systolic function, and cardiac output were assessed. BNP was compared in patients with and without right ventricular dilatation, as well as in survivors versus nonsurvivors.ResultsBNP was elevated in mechanically ventilated patients with acute lung injury (median 420 pg/ml; 25-75% interquartile range 156-728 pg/ml). There was no difference between patients with and without right ventricular dilatation (420 pg/ml, 119-858 pg/ml vs. 387 pg/ml, 156-725 pg/ml; p = 0.96). There was no difference in BNP levels between the patients who died and those who survived at 30 days (420 pg/ml, 120-728 pg/ml vs. 385 pg/ml, 159-1070 pg/ml; p = 0.71).ConclusionsIn patients with acute lung injury the level of BNP is increased, but there is no difference in the BNP level between patients with and without right ventricular dilatation. Furthermore, BNP level is not predictive of mortality in this population.
Highlights
B-type natriuretic peptide (BNP) has been shown to be useful for the diagnosis of congestive heart failure (CHF) in patients presenting with acute dyspnea [1]
BNP level was elevated in mechanically ventilated patients with acute lung injury (ALI)
There was no difference in BNP levels between the patients who died and those who survived (420 pg/ml vs. 385 pg/ml, p = 0.71; Figure 2)
Summary
B-type natriuretic peptide (BNP) has been shown to be useful for the diagnosis of congestive heart failure (CHF) in patients presenting with acute dyspnea [1]. In patients with CHF, BNP levels correlate with ventricular filling pressures and predict adverse outcome [2,3]. In patients with hypoxic respiratory failure due to pulmonary edema, several recent studies have examined the utility of BNP to distinguish patients with cardiogenic pulmonary edema from patients with acute lung injury (ALI) [8,9,10,11]. The primary objective of this study was to examine levels of B-type natriuretic peptide (BNP) in mechanically ventilated patients with acute lung injury and to test whether the level of BNP would be higher in patients with right ventricular dilatation and would predict mortality
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