Correlations between NT-proBNP, outcome and haemodynamics in patients with septic shock

Acta Cardiol. 2015 Oct;70(5):545-52. doi: 10.2143/AC.70.5.3110515.

Abstract

Aim: 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.

Keywords: NT-proBNP; Septic shock; haemodynamics; natriuretic peptides; polymyxin B; prognosis.

MeSH terms

  • Aged
  • Area Under Curve
  • Biomarkers / blood
  • Female
  • Hemodynamics*
  • Humans
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Risk Factors
  • Severity of Illness Index
  • Shock, Septic / blood*
  • Shock, Septic / diagnosis
  • Shock, Septic / mortality
  • Shock, Septic / physiopathology
  • Shock, Septic / therapy
  • Survival Analysis
  • Time Factors
  • Up-Regulation

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain