Utility of B-type Natriuretic Peptide in Patients with Acute Respiratory Distress Syndrome.

Rhee, Chin Kook; Joo, Young Bin; Kim, Seok Chan; Park, Sung Hak; Lee, Sook Young; Koh, Yoon Seok; Kim, Young Kyoon

doi:2007.62.5.389

Tuberc Respir Dis > Volume 62(5); 2007 > Article

Original Article

Tuberculosis and Respiratory Diseases 2007;62(5):389-397.
DOI: https://doi.org/10.4046/trd.2007.62.5.389 Published online May 1, 2007.

Utility of B-type Natriuretic Peptide in Patients with Acute Respiratory Distress Syndrome.

Chin Kook Rhee, Young Bin Joo, Seok Chan Kim, Sung Hak Park, Sook Young Lee, Yoon Seok Koh, Young Kyoon Kim

¹Divison of Respiratory & Critical Care Medicine, Department of Internal Medicine, Kangnam St. Mary's Hospital, The Catholic University of Korea, Korea. youngkim@catholic.ac.kr
²Divison of Cardiology Medicine, Department of Internal Medicine, Kangnam St. Mary's Hospital, Seoul, Korea.

Abstract

BACKGROUND
B-type natriuretic peptide (BNP) has been shown to be strong mortality predictors in a wide variety of cardiovascular syndromes. Little is known about BNP in patients with acute respiratory distress syndrome (ARDS). We studied whether BNP can predict mortality in patients with ARDS. METHOD: Echocardiographic study was done to all patients with ARDS, and we excluded patient with low ejection fraction (less than 50%) or showing any features of diastolic dysfunction. 47 patients were enrolled between December, 2003 and February, 2006. Parameters including BNP were obtained within 24h hours at the time of enrollment. RESULT: Mean BNP concentrations and APACHE II scores differed between the survivors and nonsurvivors (BNP, 219.5 +/- 57.7 pg/mL vs 492.3 +/- 88.8 pg/mL; p=0.013, APACHE II score, 17.4 +/- 1.6 vs 23.1 +/- 1.3, p=0.009, respectively). With the use of the threshold value for BNP of 585 pg/mL, the specificity for the prediction of mortality was 94%. The threshold value for APACHE II of 15.5 showed sensitivity of 87%. 'APACHE II + 11xlogBNP' showed sensitivity 63%, and specificity 82%, using threshold value for 46.14. CONCLUSION: BNP concentrations and APCHE II scores were more elevated in nonsurvivors than survivors in patients with ARDS who have normal ejection fraction. BNP can predict mortality. Further study should be done.

Key Words: Acute Respiratory Distress Syndrome (ARDS), B-type natriuretic peptide (BNP), Mortality, Prognosis