The effects of acute fluid loading on plasma B-type natriuretic peptide levels in a septic shock patient.
A 64-year-old female patient was admitted to a general intensive care unit with sustained hypotension resulting from severe sepsis. Her admission plasma B-type natriuretic peptide was elevated (407 pg/ml), and echocardiogram displayed normal ventricular dimensions and function. The right ventricular end-diastolic diameter increased with acute fluid loading, and this coincided with a parallel increase in B-type natriuretic peptide. Subsequent fluid depletion was accompanied by a reduction in both right ventricular end-diastolic diameter and B-type natriuretic peptide. The present case indicates that acute fluid loading may alter plasma B-type natriuretic peptide levels, and highlights the importance of taking the clinical context into account when interpreting these levels.
Mclean
A S
AS
Department of Intensive Care Medicine, University of Sydney (Nepean Campus), Penrith, New South Wales.
Poh
G
G
Huang
S J
SJ
D003404:Creatinine / Q000097:blood; D004562:Electrocardiography / Q000379:methods; D017809:Fatal Outcome; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006325:Heart Atria / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D007022:Hypotension / Q000097:blood / Q000209:etiology / Q000628:therapy; D007442:Intubation, Intratracheal / Q000379:methods; D008875:Middle Aged; D009102:Multiple Organ Failure; D045265:Natriuretic Peptides / Q000097:blood*; D009638:Norepinephrine / Q000008:administration & dosage; D011175:Positive-Pressure Respiration / Q000379:methods; D018805:Sepsis / Q000175:diagnosis / Q000188:drug therapy; D012772:Shock, Septic / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D014463:Ultrasonography; D014662:Vasoconstrictor Agents / Q000008:administration & dosage; D014667:Vasopressins / Q000008:administration & dosage
D045265:Natriuretic Peptides; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D003404:Creatinine; D009638:Norepinephrine