PulseExploreJournal ClubDebatesTrendingResearchersJournals
Instagram
HomeExploreJournal ClubTrending
Synapse
⌘+K
Synapse
February 1, 2003Anaesthesia and Intensive Care89 citationsOpen Access

Increased B-type Natriuretic Peptide (BNP) Level is a Strong Predictor for Cardiac Dysfunction in Intensive Care Unit Patients

View Full Paper
AMAnthony S. McLeanCardiac ImagingBTBenjamin TangNepean HospitalMNMarek NalosCharles University

Key Result

B-type natriuretic peptide (BNP) levels were significantly higher in ICU patients with cardiac dysfunction (516 vs 67 pg/ml, P<0.0001), with a 144 pg/ml cut-off yielding 92% sensitivity.

Key Points

  • To assess whether B-type natriuretic peptide (BNP) can serve as a screening tool for cardiac dysfunction in ICU patients.
  • Included patients admitted to a combined medical and surgical ICU over four weeks.
  • BNP was measured upon admission using a hand-held meter; clinicians were blinded to results during diagnosis.
  • Comparison of BNP levels between patients with and without cardiac dysfunction.
  • Patients with cardiac dysfunction had a BNP level of 516 +/- 385 pg/ml (n=26) vs. 67 +/- 89 pg/ml (n=58), P < 0.0001.
  • A BNP cut-off of 144 pg/ml demonstrated 92% sensitivity, 86% specificity, and 96% negative predictive value.
  • Sensitivity improved to 96% for patients aged 55 and older.

Study Design

Type

Observational (n=84)

Blinding

Single-blind (clinicians blinded to BNP measurement)

Structured PICO

Does BNP measurement on admission accurately screen for clinically significant cardiac dysfunction in ICU patients?

P
Population
84 patients admitted to a combined medical and surgical ICU over a four-week period, evaluated for the diagnostic utility of BNP for cardiac dysfunction.
E
Exposure
B-type natriuretic peptide (BNP) measurement on admission using a hand-held meter.
C
Comparator
Clinical diagnosis of clinically significant cardiac dysfunction (clinicians blinded to BNP levels).
O
Outcome
Diagnostic accuracy (sensitivity, specificity, negative predictive value) of BNP for detecting cardiac dysfunction.surrogate

Point-of-admission BNP measurement is a highly sensitive and specific screening tool for identifying underlying cardiac dysfunction in ICU patients.

Main Result

Absolute Event Rate: 516% vs 67%

p-value: p=< 0.0001

Abstract

Patients admitted to an Intensive Care Unit (ICU) frequently have underlying cardiac dysfunction. Early interventions are sometimes difficult to initiate because of diagnostic uncertainty as to whether cardiac failure is present As B-type natriuretic peptide (BNP) has been shown to be increased in cardiac dysfunction, we sought to demonstrate whether BNP can be used as a screening tool for cardiac dysfunction in patients admitted to ICU. All patients admitted to a combined medical and surgical ICU over a four-week period were included in the study. BNP was measured on the point of admission using a hand-held meter. Clinicians were blinded from the measurement when diagnoses were made as to whether or not the patients had clinically significant cardiac dysfunction. Patients with cardiac dysfunction had a significantly higher level of BNP when compared to the non-cardiac dysfunction group: 516 +/- 385 pg/ml (n = 26) v 67 +/- 89 pg/ml (n = 58) (P or = 55 years. At this cut-off value, BNP is a strong predictor of cardiac dysfunction. BNP measurement offers a rapid and affordable way to screen for cardiac dysfunction in patients admitted to ICU. An increased BNP level warrants further cardiac investigations so as to implement early interventions for cardiac decompensation in ICU patients.

Ask AI
Helpful
Bookmark
Share
View Full Paper

Cite This Study

McLean et al. (2003) conducted an observational in Cardiac dysfunction (n=84). B-type natriuretic peptide (BNP) level vs. Patients without cardiac dysfunction was evaluated on BNP level (pg/ml) (p=< 0.0001). B-type natriuretic peptide (BNP) levels were significantly higher in ICU patients with cardiac dysfunction (516 vs 67 pg/ml, P<0.0001), with a 144 pg/ml cut-off yielding 92% sensitivity.

synapsesocial.com/papers/6a1fe168dfff2a7ea2430d3bhttps://doi.org/10.1177/0310057x0303100104
Ask AI
Helpful
Bookmark
Share
View Full Paper

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Effects of brain natriuretic peptide on hemodynamics and renal function in dogs.1990 · 23 citations
  2. 2The Limited Reliability of Physical Signs for Estimating Hemodynamics in Chronic Heart Failure1989 · 993 citations
  3. 3Atrial stretch, not pressure, is the principal determinant controlling the acute release of atrial natriuretic factor.1988 · 485 citations
  4. 4Effect of Captopril on Mortality and Morbidity in Patients with Left Ventricular Dysfunction after Myocardial Infarction1992 · 5,961 citations
  5. 5Rapid Measurement of B-Type Natriuretic Peptide in the Emergency Diagnosis of Heart Failure2002 · 3,375 citations