Plasma Brain Natriuretic Peptide and Troponin Levels in Severe Sepsis and Septic Shock

Journal of Intensive Care Medicine - Tập 29 Số 4 - Trang 229-237 - 2014
Kada Klouche1, Stephane Pommet1, Laurent Amigues1, Anne Sophie Bargnoux2, Anne‐Marie Dupuy2, Sônia Salgueiro Machado1, Marianne Serveaux-Delous1, Marion Moréna2, O. Jonquet1, Jean‐Paul Cristol2
1Department of Intensive Care Medicine, Lapeyronie University Hospital, Montpellier, France
2Department of Biochemistry, Lapeyronie University Hospital, Montpellier, France

Tóm tắt

The aim of this study was to evaluate and compare brain natriuretic peptide (BNP) and cardiac troponin I (cTnI) levels as mortality prognosticator and predictor for myocardial dysfunction in severe sepsis and septic shock. Baseline clinical and biological variables were collected from 47 patients with severe sepsis or septic shock. Ventricular systolic function assessed by echocardiography was measured over a 5-day period. Both cTnI and BNP plasmatic levels were determined at intensive care unit (ICU) admission and during the following 15 days. At admission, cTnI and BNP levels were compared to those of 12 control critically ill nonseptic patients. The plasma levels of BNP and cTnI in patients with sepsis were elevated at admission and significantly higher than in the controls. Among patients with sepsis, BNP levels were significantly more elevated in nonsurvivors compared to survivors at admission and 1 day later. The cTnI levels were also significantly more elevated in nonsurvivors compared to survivors, but only at admission. From admission to day 5, patients with sepsis with left ventricular systolic dysfunction had higher BNP plasmatic concentrations than those without; differences were significant at days 3 and 4. In contrast, plasma cTnI levels were similar between the 2 groups. In critically ill patients, sepsis induces significant increase in BNP and cTnI levels. High BNP and cTnI plasma levels during ICU admission appear to be associated with poor outcome of sepsis. Time course of BNP levels seems helpful to discriminate between surviving and nonsurviving patients with sepsis and to detect myocardial dysfunction where troponin levels fail to do so.

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Tài liệu tham khảo

10.1097/01.CCM.0000194725.48928.3A

10.7326/0003-4819-100-4-483

10.1016/S0140-6736(04)17667-8

10.1097/01.CCM.0000114827.93410.D8

10.1093/clinchem/46.5.650

10.1001/jama.290.20.2713

10.1016/j.ejheart.2005.03.003

10.1111/j.1365-2044.2004.03972.x

10.1016/j.jacc.2005.01.046

10.1056/NEJMoa020233

10.1056/NEJMoa031681

10.1056/NEJMra0800239

10.1007/s00134-003-1910-0

10.1016/S0735-1097(03)00421-2

10.1016/j.ijcard.2003.02.005

10.1007/s001340100920

10.1007/s001340050008

10.1016/j.jcrc.2009.12.001

10.1097/01.CCM.0000050454.01978.3B

10.1016/j.ccc.2010.01.001

Rudski LG, 2010, J Am Soc Echocardiogr, 23, 685, 10.1016/j.echo.2010.05.010

10.1097/01.CCM.0000162561.82012.E9

Hoffmann U, 2007, Clin Lab, 51, 373

10.1097/01.CCM.0000259469.24364.31

10.1161/CIRCULATIONAHA.104.472050

10.1007/s00134-010-2051-x

10.1097/01.shk.0000226266.99960.d0

10.1001/archsurg.2007.69

10.1097/01.CCM.0000229144.97624.90

10.1186/cc1822

10.1097/CCM.0b013e31818b9153

10.1186/cc6880

10.1016/j.ijcard.2007.03.108

10.1016/j.jcrc.2010.05.002

10.1177/0310057X1003800216

10.1016/j.ejim.2007.01.006

10.1006/jmcc.2002.2005

10.1016/j.ejim.2006.07.013

10.2174/092986709789352330

10.1097/01.ccx.0000135514.20538.44

10.1007/s001340051030

10.1177/0310057X0803600109

10.1007/s00134-007-0816-7

Turner KL, J Am Coll Surg

10.1097/01.CCM.0000094225.18237.20

10.1097/CCM.0b013e318183f067

10.1016/j.jcrc.2011.06.017

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Thông tin xuất bản

Journal of Intensive Care Medicine

Tập 29 Số 4

229-237

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