Abstract | BACKGROUND: METHODS: RESULTS: Eighty patients were enrolled. Median BNP was 325 pg/mL (interquartile range [IQR], 82 to 767 pg/mL) in acute lung injury/ARDS patients, vs 1,260 pg/mL (IQR, 541 to 2,020 pg/mL) in CPE patients (p = 0.0001). The correlation between BNP and pulmonary capillary wedge pressure was modest (r = 0.27, p = 0.02). BNP offered good discriminatory performance for the final diagnosis (C-statistic, 0.80). At a cut point </= 200 pg/mL, BNP provided specificity of 91% for ARDS. At a cut point >/= 1,200 pg/mL, BNP had a specificity of 92% for CPE. Higher levels of BNP were associated with a decreased odds for ARDS (odds ratio, 0.4 per log increase; p = 0.007) after adjustment for age, history of CHF, and right atrial pressure. BNP was associated with in-hospital mortality (p = 0.03) irrespective of the final diagnosis and independent of APACHE (acute physiology and chronic health evaluation) II score. CONCLUSION: In ICU patients with hypoxemic respiratory failure, BNP appears useful in excluding CPE and identifying patients with a high probability of ARDS, and was associated with mortality in patients with both ARDS and CPE. Larger studies are necessary to validate these findings.
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Authors | Dimitri Karmpaliotis, Ajay J Kirtane, Christopher P Ruisi, Tamar Polonsky, Atul Malhotra, Daniel Talmor, Ioanna Kosmidou, Petr Jarolim, James A de Lemos, Marc S Sabatine, C Michael Gibson, David Morrow |
Journal | Chest
(Chest)
Vol. 131
Issue 4
Pg. 964-71
(Apr 2007)
ISSN: 0012-3692 [Print] United States |
PMID | 17426196
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Natriuretic Peptide, Brain
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Topics |
- Aged
- Aged, 80 and over
- Biomarkers
(blood)
- Cardiac Catheterization
- Diagnosis, Differential
- Disease Progression
- Female
- Follow-Up Studies
- Heart Failure
(blood, complications, diagnosis)
- Hospitalization
- Humans
- Hypoxia
(blood, diagnosis, etiology)
- Immunoassay
- Intensive Care Units
- Male
- Middle Aged
- Natriuretic Peptide, Brain
(blood)
- Prognosis
- Pulmonary Edema
(blood, complications, diagnosis)
- Pulmonary Wedge Pressure
- Respiratory Insufficiency
(blood, diagnosis, etiology)
- Retrospective Studies
- Stroke Volume
- Ventricular Function, Right
- Ventricular Pressure
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