title: [Change in plasma brain natriuretic peptide and its clinical significance in burn patients after delayed fluid resuscitation of shock].
abstract: OBJECTIVE
  To observe the early change in plasma brain natriuretic peptide (BNP) level in burn patients with long delayed fluid resuscitation of burn shock and its clinical significance.
  
  
  METHODS
  Thirty-six burn patients with second and third degree of burn covering 32%-92% total body surface area were enrolled for the study, among them 10 patients were complicated with serious heart failure (heart failure group), and 26 patients rallied from shock after delayed fluid resuscitation without heart failure (stable group). The level of plasma BNP, lactate dehydrogenase (LDH), MB isoenzyme of creatine kinase (CK-MB), and left ventricle ejection fraction (LVEF) were determined at admission and 3 hours after hospitalization, and 24, 48, 72, 168 hours after the injury in both groups with electrochemiluminescence (ECL).
  
  
  RESULTS
  Compared with stable group, the plasma BNP level (ng/L) of heart failure group at 3 hours after hospitalization, and 24, 48, 72 hours after the burn injury increased significantly (3 hours after hospitalization: 1 521.38+/-121.11 vs. 391.36+/-63.27, 24 hours after burn: 2 516.86+/-193.25 vs. 360.79+/-146.56, 48 hours after burn: 1 587.76+/-169.23 vs. 398.92+/-77.46, 72 hours after burn: 974.45+/-166.33 vs. 283.43+/-68.15, all P<0.01), the level of LVEF lowered significantly (3 hours after hospitalization : 0.33+/-0.03 vs. 0.58+/-0.09, 24 hours after burn: 0.36+/-0.09 vs. 0.60+/-0.10, 48 hours after burn: 0.35+/-0.08 vs. 0.62+/-0.11, 72 hours after burn: 0.39+/-0.10 vs. 0.64+/-0.10, all P<0.05). The levels of LDH (micromolxs(-1) xL(-1)) in stable group were 2.87+/-0.50 at admission, 3.02+/-0.43 3 hours after hospitalization, 4.02+/-0.87 24 hours after burn, 6.90+/-0.87 48 hours after burn, 3.64+/-0.75 72 hours after burn, 2.67+/-0.45 168 hours after burn while in heart failure group, they were 2.97+/-1.40, 3.84+/-0.37, 4.29+/-0.45, 8.50+/-0.38, 3.84+/-0.62, 2.30+/-0.38, respectively; and CK-MB (U/L) in stable group were 59.12+/-13.75 at admission, 70.39+/-10.72 3 hours after hospitalization, 79.29+/-17.27 24 hours after burn, 67.44+/-12.77 48 hours after burn, 30.28+/-7.13 72 hours after burn, 21.44+/-3.15 168 hours after burn while in heart failure group, they were 65.76+/-16.38, 81.46+/-7.92, 86.43+/-14.19, 72.53+/-11.27, 36.39+/-6.18, 22.85+/-7.26, respectively. No statistically significant difference was found in changes in both LDH and CK-MB between two groups (all P>0.05).
  
  
  CONCLUSIONS
  Determination of the plasma BNP is a simple and useful method in detecting heart failure during resuscitation of shock after a serious burn injury.
authors.affiliation: Department of Burns and Plastic Surgery, the First Medical Hospital Affiliated to General Hospital of Fuzhou Command, Putian 351100, Fujian, China.
authors.forename: Yong-xin
authors.initials: YX
authors.lastname: Huang
authors.forename: Xin-hua
authors.initials: XH
authors.lastname: Zhan
authors.forename: Jing-wei
authors.initials: JW
authors.lastname: Zheng
authors.forename: Zu-huang
authors.initials: ZH
authors.lastname: Wu
authors.forename: Jian-chong
authors.initials: JC
authors.lastname: Chen
authors.forename: Jian-xian
authors.initials: JX
authors.lastname: Zhu
authors.forename: Bao-gen
authors.initials: BG
authors.lastname: Xie
authors.forename: Shi-kang
authors.initials: SK
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005440:Fluid Therapy; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012151:Resuscitation / Q000379:methods*; D012769:Shock / Q000097:blood* / Q000209:etiology / Q000628:therapy; D055815:Young Adult
chemical_list: D020097:Natriuretic Peptide, Brain