Prognostic values of B-type natriuretic peptide in severe sepsis and septic shock.
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.
McLean
Anthony S
AS
Department of Intensive Care Medicine, University of Sydney, Nepean Hospital, Sydney, NSW, Australia. mcleana@med.usyd.edu.au
Huang
Stephen J
SJ
Hyams
Stephanie
S
Poh
Genie
G
Nalos
Marek
M
Pandit
Rahul
R
Balik
Martin
M
Tang
Ben
B
Seppelt
Ian
I
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
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain