- Poster presentation
- Open access
- Published:
High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery
Critical Care volume 16, Article number: P127 (2012)
Introduction
Failure to wean from mechanical ventilation is related to worse outcomes after cardiac surgery. The aim of the study was to evaluate B-type natriuretic peptide (BNP) as a predictor factor of failure to wean from mechanical ventilation after cardiac surgery.
Methods
We conducted a prospective and observational cohort study of 101 patients that underwent on-pump coronary artery bypass grafting. BNP was measured postoperatively after ICU admission and at the end of a spontaneous breathing test (SBT). Demographic data, hemodynamic and respiratory parameters, fluid balance, need for vasopressor or inotropic support, lengths of ICU and hospital stay were recorded. Weaning failure was considered as either the inability to sustain spontaneous breathing after 60 minutes or the need for reintubation within 48 hours.
Results
BNP levels were significantly higher both at ICU admission and in the end of breathing test in patients with weaning failure than in the other patients. A BNP concentration of 299 ng/l at the end of the SBT identified weaning failure with 92% sensitivity and 87% specificity, resulting in an area under the curve value of 0.91 (95% CI (0.86 to 0.97), P < 0.001) (Figure 1). In a multivariate model, BNP level at the end of SBT was the only predictor of weaning failure from mechanical ventilation.
Area under receiving operating characteristic curve for BNP-2 (at the end of spontaneous breathing test) to predict weaning failure.
Conclusion
BNP was an independent predictor factor of failure to wean from mechanical ventilation after cardiac surgery, which suggests that optimization of the ventricular function must be a goal prior to liberation from mechanical ventilation.
Author information
Authors and Affiliations
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Hajjar, L., Lara, T., Almeida, J. et al. High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery. Crit Care 16 (Suppl 1), P127 (2012). https://doi.org/10.1186/cc10734
Published:
DOI: https://doi.org/10.1186/cc10734