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  • Open Access

Can N-terminal pro-B-type natriuretic peptide and troponin T predict ICU and hospital mortality in patients with septic shock?

  • 1,
  • 1,
  • 1 and
  • 1
Critical Care200610 (Suppl 1) :P192

https://doi.org/10.1186/cc4539

  • Published:

Keywords

  • Left Ventricle
  • Septic Shock
  • Severe Sepsis
  • Natriuretic Peptide
  • Prognostic Marker

Introduction

The counter-regulatory neurohormone N-terminal pro-B-type natriuretic peptide (NT-proBNP) is predominantly released from the left ventricle in response to increasing wall tension and is a useful prognostic marker in patients with-established cardiac failure [1]. Myocardial dysfunction commonly occurs in septic patients. Cardiac biomarkers, including NT-proBNP, have been shown to be predicators of mortality in unselected critically ill patients [2].

Objectives

To evaluate the role of NT-proBNP and troponin T (TnT) as predictors of mortality in patients with severe sepsis and septic shock.

Methods

A prospective observational study was carried out on patients admitted to a noncardiothoracic tertiary ICU within 24 hours of the development of severe sepsis or septic shock. Plasma samples were taken on all patients on admission. NT-proBNP and TnT were determined using commercially available assays. Data were compared after logarithmic transformation, where appropriate.

Results

Thirty-four patients met the entry criteria (mean age 61.3 ± 14.9 years, male n = 19, all patients were mechanically ventilated). The APACHE II score of ICU survivors (median [range]) was 19 (12–33) and for nonsurvivors was 22.5 (14–38) (P = 0.19). Of the 34 patients, 11 died during their ICU admission (32%). Hospital mortality was 15/34 (44%). NT-proBNP was elevated (>150 ng/l) in all patients and TnT (>0.1 ng/ml) in 13 patients. Results are summarised in Table 1.
Table 1

ICU and hospital outcomes related to admission NT-proBNP and TnT levels

 

Outcome

Survivors

Nonsurvivors

P value

NT-proBNP

ICU

8514 (1943–31,290)

8171 (4279–28,269)

0.7

TnT

ICU

0.05 (0.01–0.18)

0.07 (0.04–0.22)

0.37

NT-proBNP

Hospital

6291 (1943–30,345)

23541 (4279–30,416)

0.4

TnT

Hospital

0.05 (0.01–0.15)

0.07 (0.03–0.28)

0.37

Data presented as median (interquartile range).

Conclusion

NT-pro-BNP and TnT are frequently elevated in severe sepsis. However admission values are not prognostic markers of ICU and hospital survival.

Authors’ Affiliations

(1)
James Cook University Hospital, Middlesbrough, UK

References

  1. Doust JA, et al.: BMJ. 2005, 330: 625. 10.1136/bmj.330.7492.625PubMed CentralView ArticlePubMedGoogle Scholar
  2. Meyer B, et al.: . Crit Care 2004,9(Suppl 1):P329. 10.1186/cc3392View ArticleGoogle Scholar

Copyright

© BioMed Central Ltd 2006

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