• S Thierry, L Lecuyer, E Brocas, A Van de Louw, S Hours, M-H Moreau, R Boiteau, and A Tenaillon.
• Service de Réanimation Polyvalente, Hôpital Louise-Michel, Centre Hospitalier Sud-Francilien, 91014 Evry, France. stephane.thierry@ch-sud-francilien.fr
• Ann Fr Anesth Reanim. 2006 Aug 1;25(8):815-9.

ObjectiveThe aim of this study was to evaluate the accuracy of the BNP as a marker of acute cor pulmonale in patients with ARDS.Study DesignProspective clinical trial.Patients And MethodsAt day 2 or 3 after the onset of the ARDS, an echocardiography was performed. Patients with left ventricular dysfunction were excluded. Right ventricular area (RVA) and RVA/LVA ratio were measured. ACP was defined as RVA/LVA > 0.6 associated with septal dyskinesia. Simultaneously, 5 ml of blood was collected for BNP measurement.Results26 patients were studied. BNP levels were higher in 10 patients with ACP: 585.5 [189-4830] vs 145.5 [36.5-346] pg/ml (P=0.01) but in those with creatinine clearance < 90 ml/min: 602 [331-3530] vs 125 [39-189] pg/ml (P=0.007). BNP was correlated with RVA (r=0.5; p=0.01), RVA/LVA ratio (r=0.61; p=0.001), sPAP (r=0.58; p=0.002) and with age, cardiac index and creatinine clearance (r=0.61; p=0.001). In multivariate analysis, BNP was only correlated with creatinine clearance (p=0.03), and RVA (p=0.06).ConclusionIn ARDS patients without left ventricular dysfunction, BNP level is more elevated in patients with acute cor pulmonale than patients without cor pulmonale.

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