Key result
Elevated admission NT-proBNP is linked to ~3-fold higher ventilatory support needs in AECOPD.
Why the study?
Identifying patients with acute exacerbation of chronic obstructive pulmonary disease at risk for respiratory failure and ventilatory support is crucial, and the prognostic value of admission NT-proBNP for hospital outcomes needed evaluation.
Does an elevated admission plasma NT-proBNP level (≥150 pg/mL) predict the need for ventilatory support and adverse hospital outcomes in patients hospitalized with acute exacerbations of COPD?
Cross-Sectional (n=70)
No
Does an elevated admission plasma NT-proBNP level (≥150 pg/mL) predict the need for ventilatory support and adverse hospital outcomes in patients hospitalized with acute exacerbations of COPD?
In patients hospitalized with acute exacerbations of COPD without systolic heart failure, elevated admission NT-proBNP (≥150 pg/mL) is associated with worse gas exchange, higher pulmonary artery pressures, and a significantly greater need for ICU admission and mechanical ventilation.
Answers are grounded in this paper and cite their sources.
May support risk stratification in AECOPD; hypothesis-generating and requires prospective validation before clinical adoption.
Background: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a major cause of morbidity and mortality worldwide. Identifying patients at risk for respiratory failure and ventilatory support is crucial for optimal management. N-terminal pro-brain natriuretic peptide (NTproBNP), a marker of cardiac wall stress, may have prognostic value in AECOPD. Objective: To evaluate the association between admission NT-proBNP levels and the need for ventilatory support and hospital outcomes in patients with AECOPD. Methods: This cross-sectional analytical study was conducted at the Department of Respiratory Medicine, National Institute of the Diseases of the Chest & Hospital (NIDCH), Dhaka, Bangladesh, from July 2018 to June 2019. A total of 70 patients with AECOPD were enrolled. Plasma NT-proBNP was measured within 24 hours of admission. Patients were categorized into normal (<150 pg/mL) and elevated (≥150 pg/mL) NT-proBNP groups. Need for ventilatory support (NIPPV/IPPV), ICU admission, length of hospital stay, and in-hospital mortality were recorded. Results: The mean age was 61.77±8.91 years, with male predominance (95.7%). Elevated NT-proBNP was significantly associated with lower SpO₂ (85.12 vs 88.0, p=0.002), lower PaO₂ (62.93 vs 73.28, p=0.002), higher PaCO₂ (55.71 vs 51.55, p<0.001), and higher PASP (49.02 vs 37.53, p=0.010). Patients with elevated NT-proBNP more frequently required ICU admission (55.8% vs 16.7%, p=0.004) and ventilatory support (NIPPV: 36.5% vs 11.1%; IPPV: 19.2% vs 5.6%; p=0.016). No significant differences were observed in mortality (11.5% vs 5.6%, p=0.466) or hospital stay duration (p=0.915). Conclusions: Elevated admission NT-proBNP is significantly associated with worse gas exchange, pulmonary hypertension, and increased need for ICU admission and ventilatory support in AECOPD patients. NT-proBNP may serve as a useful biomarker for early risk stratification.
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Anach et al. (2026) conducted a cross-sectional in Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (n=70). Elevated admission plasma NT-proBNP (>=150 pg/mL) vs. Normal admission plasma NT-proBNP (<150 pg/mL) was evaluated on Need for ventilatory support (NIPPV or IPPV) (p=0.016). Elevated admission NT-proBNP (>=150 pg/mL) was significantly associated with increased need for ventilatory support (36.5% vs 11.1% for NIPPV; 19.2% vs 5.6% for IPPV; p=0.016) and ICU admission (55.8% vs 16.7%, p=0.004) in AECOPD patients.
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