Key result
In multiple injured patients, serum NT-proBNP levels were significantly higher in those developing major organ dysfunction compared to minor dysfunction at 24 hours (729 vs 201 pg/mL, p<0.001).
Why the study?
Does NT-proBNP correlate with cardiac index and MODS severity in multiple injured patients?
Cohort (n=26)
No
Does NT-proBNP correlate with cardiac index and MODS severity in multiple injured patients?
Answers are grounded in this paper and cite their sources.
In multiple injured patients, elevated NT-proBNP levels correlate with the severity of multiple organ dysfunction syndrome and decreased cardiac index, suggesting potential utility in diagnosing post-traumatic cardiac impairment.
INTRODUCTION: Increased serum B-type natriuretic peptide (BNP) has been identified for diagnosis and prognosis of impaired cardiac function in patients suffering from congestive heart failure, ischemic heart disease, and sepsis. However, the prognostic value of BNP in multiple injured patients developing multiple organ dysfunction syndrome (MODS) remains undetermined. Therefore, the aims of this study were to assess N-terminal pro-BNP (NT-proBNP) in multiple injured patients and to correlate the results with invasively assessed cardiac output and clinical signs of MODS. METHODS: Twenty-six multiple injured patients presenting a New Injury Severity Score of greater than 16 points were included. The MODS score was calculated on admission as well as 24, 48, and 72 hours after injury. Patients were subdivided into groups: group A showed minor signs of organ dysfunction (MODS score less than or equal to 4 points) and group B suffered from major organ dysfunction (MODS score of greater than 4 points). Venous blood (5 mL) was collected after admission and 6, 12, 24, 48, and 72 hours after injury. NT-proBNP was determined using the Elecsys proBNP(R) assay. The hemodynamic monitoring of cardiac index (CI) was performed using transpulmonary thermodilution. RESULTS: Serum NT-proBNP levels were elevated in all 26 patients. At admission, the serum NT-proBNP values were 116 +/- 21 pg/mL in group A versus 209 +/- 93 pg/mL in group B. NT-proBNP was significantly lower at all subsequent time points in group A in comparison with group B (P < 0.001). In contrast, the CI in group A was significantly higher than in group B at all time points (P < 0.001). Concerning MODS score and CI at 24, 48, and 72 hours after injury, an inverse correlation was found (r = -0.664, P < 0.001). Furthermore, a correlation was found comparing MODS score and serum NT-proBNP levels (r = 0.75, P < 0.0001). CONCLUSIONS: Serum NT-proBNP levels significantly correlate with clinical signs of MODS 24 hours after multiple injury. Furthermore, a distinct correlation of serum NT-proBNP and decreased CI was found. The data of this pilot study may indicate a potential value of NT-proBNP in the diagnosis of post-traumatic cardiac impairment. However, further studies are needed to elucidate this issue.
No takes yet. Share an insight, caveat, or question.
Kirchhoff et al. (2008) conducted a cohort in Multiple injury (n=26). Major organ dysfunction (MODS score > 4) vs. Minor organ dysfunction (MODS score ≤ 4) was evaluated on Serum NT-proBNP levels at 24 hours (pg/mL) (p=<0.001). In multiple injured patients, serum NT-proBNP levels were significantly higher in those developing major organ dysfunction compared to minor dysfunction at 24 hours (729 vs 201 pg/mL, p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: