| The Usefulness of B-type Natriuretic Peptide test in Critically Ill, Noncardiac Patients. |
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Kang Ho Kim, Hong Hoon Park, Esther Kim, Seok Cheol Cheon, Ji Hyun Lee, Stephen YongGu Lee, Ji Hyun Lee, In Jai Kim, Dong hoon Cha, Sehyun Kim, Jeongeun Choi, Sang Bum Hong |
1Department of Internal Medicine, Bundang CHA Hospital, College of Medicine, Pochon CHA University, Korea. sbhong@cha.ac.kr
2Department of Preventive Medicine, Bundang CHA Hospital, College of Medicine, Pochon CHA University, Korea.
3Department of Internal Medicine, Kwandong University, Korea. |
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| Abstract |
BACKGROUND
Previous studies have suggested that a B-type natriuretic peptide(BNP) test can provide important information on diagnosis, as well as predicting the severity and prognosis of heart failure. Myocardial dysfunction is often observed in critically ill noncardiac patients admitted to the Intensive Care Unit, and the prognosis of the myocardial dysfunction needs to be determined. This study evaluated the predictability of BNP on the prognosis of critically ill noncardiac patients. METHODS: 32 ICU patients, who were hospitalized from June to October 2002 and in whom the BNP test was evaluated, were enrolled in this study. The exclusion criteria included the conditions that could increase the BNP levels irrespective of the severity, such as congestive heart failure, atrial fibrillation, ischemic heart disease, and renal insufficiencies. A triage B-Type Natriuretic Peptide test with a RIA-kit was used for the fluorescence immunoassay of BNP test. In addition, the acute physiology and the chronic health evaluation (APACHE)IIscore and mortality were recorded. RESULTS: There were 16 males and 16 females enrolled in this study. The mean age was 59 years old. The mean BNP levels between the ICU patients and control were significantly different (186.7+/-274.1pg/mL vs. 19.9+/-21.3 pg/mL, p=0.033). Among the ICU patients, there were 14(44%) patients with BNPlevels above 100 pg/mL. The APACHEIIscore was 16.5+/-7.6. In addition, there were 11 mortalities reported. The correlation between the BNP and APACHEIIscore, between the BNP and mortality were significant (r=0.443, p=0.011 & r=0.530, p=0.002). The mean BNP levels between the dead and alive groups were significantly different (384.1+/-401.7 pg/mL vs. 83.2+/-55.8 pg/mL p=0.033). However, the PaO2/FiO2 did not significantly correlate with the BNP level. CONCLUSION: This study evaluated the BNP level was elevated in critically ill, noncardiac patients. The BNP level could be a useful, noninvasive tool for predicting the prognosis of the critically ill, noncardiac patients. |
| Key Words:
B-type natriuretic peptide(BNP), APACHE II score, Critically ill noncardiac patient |
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