title: Prognostic values of B-type natriuretic peptide in severe sepsis and septic shock.
abstract: OBJECTIVE
  To investigate the changes in B-type natriuretic peptide concentrations in patients with severe sepsis and septic shock and to investigate the value of B-type natriuretic peptide in predicting intensive care unit outcomes.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  General intensive care unit.
  
  
  METHODS
  Forty patients with severe sepsis or septic shock.
  
  
  METHODS
  None.
  
  
  RESULTS
  B-type natriuretic peptide measurements and echocardiography were carried out daily for 10 consecutive days. In-hospital mortality and length of stay were recorded. The admission B-type natriuretic peptide concentrations were generally increased (747 +/- 860 pg/mL). B-type natriuretic peptide levels were elevated in patients with normal left ventricular systolic function (568 +/- 811 pg/mL), with sepsis-related reversible cardiac dysfunction (630 +/- 726 pg/mL), and with chronic cardiac dysfunction (1311 +/- 1097 pg/mL). There were no significance changes in B-type natriuretic peptide levels over the 10-day period. The daily B-type natriuretic peptide concentrations for the first 3 days neither predicted in-hospital mortality nor correlated with length of intensive care unit or hospital stay.
  
  
  CONCLUSIONS
  B-type natriuretic peptide concentrations were increased in patients with severe sepsis or septic shock regardless of the presence or absence of cardiac dysfunction. Neither the B-type natriuretic peptide levels for the first 3 days nor the daily changes in B-type natriuretic peptide provided prognostic value for in-hospital mortality and length of stay in this mixed group of patients, which included patients with chronic cardiac dysfunction.
authors.affiliation: Department of Intensive Care Medicine, University of Sydney, Nepean Hospital, Sydney, NSW, Australia. mcleana@med.usyd.edu.au
authors.forename: Anthony S
authors.initials: AS
authors.lastname: McLean
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Huang
authors.forename: Stephanie
authors.initials: S
authors.lastname: Hyams
authors.forename: Genie
authors.initials: G
authors.lastname: Poh
authors.forename: Marek
authors.initials: M
authors.lastname: Nalos
authors.forename: Rahul
authors.initials: R
authors.lastname: Pandit
authors.forename: Martin
authors.initials: M
authors.lastname: Balik
authors.forename: Ben
authors.initials: B
authors.lastname: Tang
authors.forename: Ian
authors.initials: I
authors.lastname: Seppelt
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D004452:Echocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000175:diagnosis* / Q000401:mortality; D012772:Shock, Septic / Q000175:diagnosis / Q000401:mortality
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain