title: Correlations between NT-proBNP, outcome and haemodynamics in patients with septic shock.
abstract: OBJECTIVE
  The aim of this study was to determine the role of NT-proBNP in predicting the outcome of septic patients and to evaluate possible correlations between NT-ProBNP and haemodynamics in sepsis.
  
  
  METHODS
  Forty consecutive patients with severe sepsis were prospectively evaluated. Patients were treated with the gold standard therapy for sepsis. NT-BNP levels, endotoxin activity (EA), SOFA score and SAPS II score, cardiac index (CI), mean arterial pressure (MAP) and pulmonary arterial pressure (PAP) were evaluated at admission and after 72 hours. Survival was evaluated at 28 days after admission.
  
  
  RESULTS
  At 4-week follow-up, 22 patients had died (55%). Survival was not associated with age, gender, baseline EA and treatment, while it was associated with NT-proBNP levels at admission and after 72 hours. NT-proBNP>1,000 pg/ml at 72 hours was a robust independent predictor of survival. The area under the curve (AUC) of NT-proBNP at admission was 0.73 and 0.99 after 72 hours. At 72 hours, AUC for SOFA score was 0.94, for SAPS II score 1, for EA 0.73. Levels of NT-proBNP>1,000 pg/ml at 72 hours were associated with an adverse outcome (sensitivity 95.5%, specificity 94.4%). NT-proBNP at 72 hours correlated with CI, MAP and PAP (P<0.01, <0.01,<0.05 respectively).
  
  
  CONCLUSIONS
  Increased NT-proBNP levels at 72 hours could predict mortality at 28 days in patients with septic shock and are correlated with haemodynamics.
authors.forename: Andrea Igoren
authors.initials: AI
authors.lastname: Guaricci
authors.forename: Francesco
authors.initials: F
authors.lastname: Santoro
authors.forename: Alessandro
authors.initials: A
authors.lastname: Paoletti Perini
authors.forename: Luciano
authors.initials: L
authors.lastname: Ioffredo
authors.forename: Chintan
authors.initials: C
authors.lastname: Trivedi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pontone
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Biase
authors.forename: Natale Daniele
authors.initials: ND
authors.lastname: Brunetti
mesh_terms: D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016019:Survival Analysis; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: NT-proBNP; Septic shock; haemodynamics; natriuretic peptides; polymyxin B; prognosis