Abstract

Introduction: Weaning of the patient is one of the important medical challenges. One of the most important causes of failure in weaning is cardiovascular disorders. NT-Pro-BNP is a serum marker for cardiac dysfunction. This study conducted to evaluate the level of NT-Pro-BNP during the spontaneous breathing test (SBT) in patients undergoing mechanical ventilation in ICU and its association with successful weaning. Methods: In this cross-sectional study, we enrolled 42 intubated patients who were admitted to the ICU ward of Imam Reza Hospital and were clinically weaned. After obtaining informed consent, SBT was started for the patient. One and a half hours after SBT onset, a venous blood sample was obtained and the patients were followed for SBT test success and the results were recorded. Patients were extubated in stabilized condition or continued mechanical ventilation if needed. Then Data were analyzed. Results: SBT was successful in 45.2% of patients. 54.8% of patients were male. The most common cause of hospitalization was COPD (35.7%). The mean age of patients with successful SBT was 67.53±6.14 years and in patients with unsuccessful SBT was 68.70±5.44 years. There was a significant difference between NT-Pro-BNP levels half an hour after SBT between two groups of patients with successful (7.15±31.18) and unsuccessful (59.61±196.51) SBT. NT-ProBNP changes before and half an hour after SBT in both groups were statistically significant. Conclusion: NT-Pro-BNP is a predictor criteria of success in weaning in patients and as the level of NT-Pro-BNP increases, the rate of failure in weaning increases.

Highlights

  • Weaning of the patient is one of the important medical challenges

  • Considering the importance of the subject and the different results of previous studies, this study aimed to investigate the association of NT-proBNP level during spontaneous breathing test (SBT) in patients undergoing mechanical ventilation in the intensive care unit (ICU) with successful weaning

  • Results of t test showed that there was a significant difference between NT-proBNP changes before and during SBT (P = 0.001)

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Summary

Introduction

Weaning of the patient is one of the important medical challenges. One of the most important causes of failure in weaning is cardiovascular disorder. 75%-80% of successful SBTs have had successful weaning.[3] Cardiovascular dysfunction may lead to weaning failure.[4,5,6] Diagnosis of left heart failure in intubated patients is a challenging, expensive and invasive process.[5,7,8] NT-proBNP (N-terminal portion of proBNP) is a sensitive and specific serum marker for cardiovascular dysfunction,[9,10,11] and could be useful in the diagnosis of heart failure, as much as BNP.[12] Recent studies have shown that increased (NT-proBNP) level during SBT may indicate cardiac complications leading to weaning failure rather than pulmonary complications.[13] Considering the importance of the subject and the different results of previous studies, this study aimed to investigate the association of NT-proBNP level during SBT in patients undergoing mechanical ventilation in the intensive care unit (ICU) with successful weaning

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