Volume 7 Supplement 2

23rd International Symposium on Intensive Care and Emergency Medicine

Open Access

Brain natriuretic peptide in acute brain diseases

  • V Špatenková1,
  • A Kazda3 and
  • P Škrabálek2
Critical Care20037(Suppl 2):P080

https://doi.org/10.1186/cc1969

Published: 3 March 2003

Introduction

Brain natriuretic peptide (BNP) is a member of the family of natriuretic peptide hormones, which are involved in regulation of sodium and water homeostasis. It has been proven that natriuretic peptide plays a role in sodium dysbalance in acute brain diseases, especially in Cerebral Salt Wasting Syndrome (CSWS). It is also elevated in intracranial hypertension. Now there is a method available that can assay an N terminal fragment pro brain natriuretic peptide (NT-proBNP).

Method

We retrospectively analysed 77 blood samples for NT-proBNP from 18 patients hospitalised at our ICU from February until May 2002. Seventeen patients had acute brain disease (sub-arachnoid hemorrhage [SAH], eight cases; intracerebral hemorrhage, one case; tumor, five cases; and others, five cases) and one patient had spine disease.

All patients were classified as NYHA I, and their age was between 23 and 73 years (mean age 53 years).

We investigated NT-proBNP, serum osmolality (S_osm) and sodium (S_Na+) on day 1. S_osm, S_ Na+, daily urinary loss of sodium (dU_Na+), creatinine clearance (C_krea), diuresis, income of fluids and sodium in 24 hours on day 2. Moreover, we assessed NT-proBNP changes in time. Upper reference range for NT-proBNP is 150 pg/l.

Results

Parameters ± standard deviation (SD) and correlation coefficients (r) are presented in Table 1.

Table 1

Parameter

NT-proBNP (pg/l)

S_Na+ (mmol/l)

S_Na+ (mmol/l)

S_osm (mmol/l)

S_osm (mmol/l)

dU_Na+ (mmol)

C_krea (ml/s)

Diuresis (ml)

Income of fluids (ml)

Income of Na+ (mmol)

Day

1

1

2

1

2

2

2

2

2

2

Minimum

31

132

135

278

284

207

1.2

2150

3000

254

Median

227

142

143

290

294

459

1.8

3700

4000

400

Maximum

834

149

151

314

305

735

3.1

7000

7680

590

Mean value ±

321 ±

141 ±

142 ±

292 ±

293 ±

449 ±

2.1 ±

3756 ±

4192 ±

427 ±

SD

244

5

5

11

6

160

0.6

1302

1095

91

Correlation coefficient

 

0.13

0.0006

0.34

0.003

0.10

0.12

0.2

0.20

0.17

NT-proBNP was significantly elevated in all the patients (P = 0.007) and the value did not significantly change in time (difference between two samples in 13 patients; P = 0.3), and in tree samples in eight patients (P = 0.28, P = 0.37). NT-proBNP had no correlation with other parameters measured.

Conclusion

In our retrospective study we found significant elevation of NT-proBNP in patients with acute brain disease and without sodium dysbalance. Values of NT-proBNP did not significantly change in time and did not correlate with any biochemical parameters measured.

Authors’ Affiliations

(1)
Neurocentre, Liberec Hospital
(2)
Clinical Biochemistry Department, Liberec Hospital
(3)
Postgraduate Medical School

References

  1. Berendes E, Walter M, Cullen P: Secretion of brain natriuretic peptide in patients with aneurysmal subarachnoid haemorrhage. Lancet 1997, 349: 245-249. 10.1016/S0140-6736(96)08093-2View ArticlePubMedGoogle Scholar
  2. Betjes MGH: Hyponatremia in acute brain disease: cerebral salt wasting syndrome. Eur J Internal Med 2002, 13: 9-14. 10.1016/S0953-6205(01)00192-3View ArticleGoogle Scholar
  3. Ruskoaho H, Leskinen H, Taskinen JMP, Mäntymaa P, Leppäluoto OVJ: Mechanisms of mechanical load-induced atrial natriuretic peptide secretion: role of endothelin, nitric oxide, and angiotensin II. J Mol Med 1997, 75: 876-885. 10.1007/s001090050179View ArticlePubMedGoogle Scholar

Copyright

© BioMed Central Ltd 2003

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