B-type natriuretic peptide concentrations were elevated on admission (747 +/- 860 pg/mL) in severe sepsis and septic shock but did not predict in-hospital mortality or length of stay.
Observational (n=40)
Does B-type natriuretic peptide predict in-hospital mortality and length of stay in patients with severe sepsis or septic shock?
B-type natriuretic peptide is elevated in severe sepsis and septic shock regardless of cardiac dysfunction, but it does not provide prognostic value for in-hospital mortality or length of stay.
OBJECTIVE: To investigate the changes in B-type natriuretic peptide concentrations in patients with severe sepsis and septic shock and to investigate the value of B-type natriuretic peptide in predicting intensive care unit outcomes. DESIGN: Prospective observational study. SETTING: General intensive care unit. PATIENTS: Forty patients with severe sepsis or septic shock. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: B-type natriuretic peptide measurements and echocardiography were carried out daily for 10 consecutive days. In-hospital mortality and length of stay were recorded. The admission B-type natriuretic peptide concentrations were generally increased (747 +/- 860 pg/mL). B-type natriuretic peptide levels were elevated in patients with normal left ventricular systolic function (568 +/- 811 pg/mL), with sepsis-related reversible cardiac dysfunction (630 +/- 726 pg/mL), and with chronic cardiac dysfunction (1311 +/- 1097 pg/mL). There were no significance changes in B-type natriuretic peptide levels over the 10-day period. The daily B-type natriuretic peptide concentrations for the first 3 days neither predicted in-hospital mortality nor correlated with length of intensive care unit or hospital stay. CONCLUSION: B-type natriuretic peptide concentrations were increased in patients with severe sepsis or septic shock regardless of the presence or absence of cardiac dysfunction. Neither the B-type natriuretic peptide levels for the first 3 days nor the daily changes in B-type natriuretic peptide provided prognostic value for in-hospital mortality and length of stay in this mixed group of patients, which included patients with chronic cardiac dysfunction.
McLean et al. (Fri,) ont mené une étude d'observation sur la sepsie sévère et le choc septique (n=40). La mesure du peptide natriurétique de type B (BNP) a été évaluée sur la mortalité à l'hôpital et la durée du séjour. Les concentrations de peptide natriurétique de type B étaient élevées à l'admission (747 +/- 860 pg/mL) dans la sepsie sévère et le choc septique mais ne prédisaient pas la mortalité à l'hôpital ni la durée du séjour.