Tuberc Respir Dis.  2003 Mar;54(3):311-319. 10.4046/trd.2003.54.3.311.

The Usefulness of B-type Natriuretic Peptide test in Critically Ill, Noncardiac Patients

• Kim KH
• Park HH
• Kim E
• Cheon SC
• Lee JH
• Lee SY
• Lee JH
• Kim IJ
• Cha DH
• Kim S
• Choi J
• Hong SB

• KMID: 1970580
• DOI: http://doi.org/10.4046/trd.2003.54.3.311

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.

Keyword

B-type natriuretic peptide(BNP); APACHE II score; Critically ill noncardiac patient

MeSH Terms

Atrial Fibrillation
Critical Illness*
Diagnosis
Female
Fluorescence
Heart Failure
Humans
Immunoassay
Intensive Care Units
Male
Middle Aged
Mortality
Myocardial Ischemia
Natriuretic Peptide, Brain*
Physiology
Prognosis
Renal Insufficiency
Triage
Natriuretic Peptide, Brain