• Anthony S McLean, Stephen J Huang, Stephanie Hyams, Genie Poh, Marek Nalos, Rahul Pandit, Martin Balik, Ben Tang, and Ian Seppelt.
• Department of Intensive Care Medicine, University of Sydney, Nepean Hospital, Sydney, NSW, Australia. mcleana@med.usyd.edu.au
• Crit. Care Med. 2007 Apr 1;35(4):1019-26.

ObjectiveTo investigate the changes in B-type natriuretic peptide concentrations in patients with severe sepsis and septic shock and to investigate the value of B-type natriuretic peptide in predicting intensive care unit outcomes.DesignProspective observational study.SettingGeneral intensive care unit.PatientsForty patients with severe sepsis or septic shock.InterventionsNone.Measurements And Main ResultsB-type natriuretic peptide measurements and echocardiography were carried out daily for 10 consecutive days. In-hospital mortality and length of stay were recorded. The admission B-type natriuretic peptide concentrations were generally increased (747 +/- 860 pg/mL). B-type natriuretic peptide levels were elevated in patients with normal left ventricular systolic function (568 +/- 811 pg/mL), with sepsis-related reversible cardiac dysfunction (630 +/- 726 pg/mL), and with chronic cardiac dysfunction (1311 +/- 1097 pg/mL). There were no significance changes in B-type natriuretic peptide levels over the 10-day period. The daily B-type natriuretic peptide concentrations for the first 3 days neither predicted in-hospital mortality nor correlated with length of intensive care unit or hospital stay.ConclusionB-type natriuretic peptide concentrations were increased in patients with severe sepsis or septic shock regardless of the presence or absence of cardiac dysfunction. Neither the B-type natriuretic peptide levels for the first 3 days nor the daily changes in B-type natriuretic peptide provided prognostic value for in-hospital mortality and length of stay in this mixed group of patients, which included patients with chronic cardiac dysfunction.

24 keywords...

hide…