Natriuretic Peptide Testing in ICU Patients with Shock
Author Information
Author(s): James L Januzzi, Alexander Morss, Roderick Tung, Richard Pino, Michael A Fifer, B Taylor Thompson, Elizabeth Lee-Lewandrowski
Primary Institution: Massachusetts General Hospital
Hypothesis
Can NT-proBNP levels predict mortality in ICU patients with shock?
Conclusion
High NT-proBNP levels are strongly associated with ICU mortality, while low levels can help identify patients at lower risk for death.
Supporting Evidence
- NT-proBNP levels did not correlate with cardiac filling pressures.
- Patients with NT-proBNP levels below 1,200 pg/ml had a 92% negative predictive value for cardiogenic shock.
- The mortality rate was significantly higher in patients with NT-proBNP in the highest log-quartile.
Takeaway
Doctors can use a blood test for NT-proBNP to see if a patient in the ICU is likely to get better or worse. High levels mean more risk.
Methodology
The study evaluated NT-proBNP levels in 49 ICU patients with shock and correlated them with mortality and hemodynamic parameters.
Potential Biases
Potential bias in patient selection for PAC placement.
Limitations
PAC placement was at the discretion of the physician, which may affect the generalizability of the findings.
Participant Demographics
Mean age 67.8 years, 69% male, 47% with prior heart failure.
Statistical Information
P-Value
0.03
Confidence Interval
1.8–125.2
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website