title: N-terminal prohormone B-type natriuretic peptide and weaning outcome in postoperative patients with pulmonary complications.
abstract: OBJECTIVE
  To evaluate the relationship between plasma N-terminal prohormone B-type natriuretic peptide (NT-proBNP) and weaning outcomes, and the ability of NT-proBNP level to predict weaning success, in cancer patients with pulmonary complications undergoing noncardiac major surgeries.
  
  
  METHODS
  Patients who were mechanically ventilated following postoperative respiratory failure were enrolled. NT-proBNP levels at the end of a 2-h spontaneous breathing trial were measured. Weaning was considered a success in patients who completed the trial and maintained spontaneous breathing following extubation for >48 h.
  
  
  RESULTS
  Out of 29 patients, 22 patients weaned successfully but weaning failed in 7 patients. Plasma NT-proBNP was significantly higher in the weaning failure group than in the weaning success group. For predicting weaning success, the optimal NT-proBNP threshold value at the end of the spontaneous breathing trial was <448 ng/l (receiver operating characteristic analysis; sensitivity 68.18%, specificity 85.71%, positive predictive value 93.7% and negative predictive value 46.2%).
  
  
  CONCLUSIONS
  Measuring NT-proBNP at the end of a spontaneous breathing trial may assist in predicting weaning success, as a noninvasive, quantitative and repeatable indicator of cardiac stress in patients with postsurgical respiratory failure.
authors.affiliation: Department of Intensive Care Medicine, Cancer Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Ma
authors.forename: Wei
authors.initials: W
authors.lastname: Liao
authors.forename: Junke
authors.initials: J
authors.lastname: Qiu
authors.forename: Quanguan
authors.initials: Q
authors.lastname: Su
authors.forename: Yi
authors.initials: Y
authors.lastname: Fang
authors.forename: Baochun
authors.initials: B
authors.lastname: Gu
mesh_terms: D000368:Aged; D060666:Airway Extubation; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009369:Neoplasms / Q000503:physiopathology / Q000601:surgery; D010446:Peptide Fragments / Q000097:blood*; D011183:Postoperative Complications; D012372:ROC Curve; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D016896:Treatment Outcome; D015300:Ventilator Weaning; D012122:Ventilators, Mechanical
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: N-terminal prohormone B-type natriuretic peptide (NT-proBNP); mechanical ventilation; postoperative; respiratory failure; weaning