The efficacy of B-type natriuretic peptide for early identification of blood loss in traumatic injury.
BACKGROUND
Because B-type natriuretic peptide (BNP) secretion has a direct linear correlation with intravascular volume status, it was assessed as an initial marker for blood loss (BL) in polytrauma patients.


METHODS
Hemodynamically unstable trauma patients between 18 and 45 years had serial BNP levels and hemoglobin (Hgb) levels obtained on admission, at 8 and 24 hours, and every morning during resuscitation.


RESULTS
The 14 patients were categorized into 2 groups based on the 24-hour trend in Hgb levels: clinically significant blood loss (Hgb decrease >3 g/dL) or no clinical blood loss (Hgb decrease <3 g/dL). On admission, the 5 patients in the no blood loss group had normal BNP levels, whereas the 9 patients in the BL group had below-normal BNP levels. Because patients in the BL category were resuscitated, their BNP levels normalized.


CONCLUSIONS
BNP levels below normal are indicative of intravascular volume loss in traumatically injured patients.
Kia
Michael
M
Department of General Surgery, Genesys Regional Medical Center, 1 Genesys Parkway, Grand Blanc, MI 48439, USA.
Cooley
Andrea
A
Rimmer
Greg
G
MacDonald
Taylor
T
Barber
Kimberly
K
Manion
Patricia
P
Shapiro
Brian
B
Socey
John
J
Iddings
Douglas
D
D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers; D016022:Case-Control Studies; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006470:Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000150:complications*
D015415:Biomarkers; D006454:Hemoglobins; D020097:Natriuretic Peptide, Brain