Document Detail


Clinical utility of B-type natriuretic peptide in early severe sepsis and septic shock.
MedLine Citation:
PMID:  18051697     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
B-type natriuretic peptide (BNP) has diagnostic, therapeutic, and prognostic utility in critically ill patients. For severe sepsis and septic shock patients in particular, similar clinical utility from the most proximal aspects of hospital presentation to the intensive care unit has not been examined. BNP levels were measured at 0, 3, 6, 12, 24, 36, 48, 60, and 72 hours in 252 patients presenting to the emergency department with severe sepsis and septic shock. The clinicians were blinded to the BNP levels. Elevated BNP levels (>100 pg/mL) were seen in 42% and 69% of patients on presentation and at 24 hours, respectively. Elevated BNP ranges (>230 pg/mL) were significantly associated with myocardial dysfunction and severity of global tissue hypoxia. When adjusted for age, gender, history of heart failure, renal function, organ dysfunction, and mean arterial pressure, a BNP greater than 210 pg/mL at 24 hours was the most significant independent indicator of increased mortality: odds ratio 1.061 (1.026-1.097), P < .001, 95% confidence interval. Patients with severe sepsis and septic shock often have elevated BNP levels, which are significantly associated with organ and myocardial dysfunction, global tissue hypoxia, and mortality. Serial BNP levels may be a useful adjunct in the early detection, stratification, treatment, and prognostication of high-risk patients.
Authors:
Emanuel P Rivers; James McCord; Ronny Otero; Gordon Jacobsen; Manisha Loomba
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of intensive care medicine     Volume:  22     ISSN:  0885-0666     ISO Abbreviation:  J Intensive Care Med     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-12-05     Completed Date:  2008-02-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610344     Medline TA:  J Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  363-73     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Henry Ford Hospital, Wayne State University, Detroit, Michigan, USA. erivers1@hfhs.org
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MeSH Terms
Descriptor/Qualifier:
APACHE
Aged
Analysis of Variance
Biological Markers / blood
Chi-Square Distribution
Female
Humans
Immunoassay
Logistic Models
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Sepsis / blood*
Shock, Septic / blood*
Grant Support
ID/Acronym/Agency:
U01AI066569/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
J Intensive Care Med. 2007 Nov-Dec;22(6):386-8   [PMID:  18048879 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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