title: Pro-atrial natriuretic peptide (pro-ANP) level in patients with severe sepsis and septic shock: prognostic and diagnostic significance.
abstract: BACKGROUND
  To establish the prognostic and discriminative value of the pro-atrial natriuretic peptide (pro-ANP) level in patients with severe sepsis or septic shock.
  
  
  METHODS
  An observational and prospective study was conducted on 50 critically ill patients with severe sepsis or septic shock. Measurements of the level of procalcitonin (PCT) and mid-regional pro-ANP were determined in the serum of patients with commercially available immunoluminometric tests.
  
  
  RESULTS
  The median pro-ANP level was significantly higher in non-survivors than in survivors (P < 0.05) on all consecutive days. No significant differences in the pro-ANP levels were observed in patients with severe sepsis and septic shock. There was a strong correlation between the PCT and pro-ANP levels on admission in non-survivors and in septic shock patients (r = 0.56, P = 0.007 and r = 0.43, P = 0.02, respectively).
  
  
  CONCLUSIONS
  pro-ANP evaluated in severe sepsis and septic shock patients is a valuable prognostic biomarker, but, in contrast to PCT, which is routinely used as a diagnostic marker of severe sepsis and septic shock, it does not possess diagnostic and discriminative value.
authors.affiliation: Department of Anesthesiology and Intensive Care, Wroclaw Medical University, ul. Borowska 213, Wroclaw, Poland. starling@poczta.onet.pl
authors.forename: M
authors.initials: M
authors.lastname: Lipinska-Gediga
authors.forename: M
authors.initials: M
authors.lastname: Mierzchala
authors.forename: G
authors.initials: G
authors.lastname: Durek
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000097:blood*; D001419:Bacteria / Q000302:isolation & purification; D015415:Biomarkers / Q000097:blood; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011044:Poland; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000145:classification; D012772:Shock, Septic / Q000097:blood* / Q000145:classification; D055815:Young Adult
chemical_list: D015415:Biomarkers; D009320:Atrial Natriuretic Factor