NT-PROBNP SERUM CONCENTRATIONS IN SURGICAL CRITICALLY ILL PATIENTS WITH NON-SEPTIC AND SEPTIC SHOCK

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M. W. M. H. M. N. M. H.-L. Wolfgang Koenig, Marion Schneider, “NT-PROBNP SERUM CONCENTRATIONS IN SURGICAL CRITICALLY ILL PATIENTS WITH NON-SEPTIC AND SEPTIC SHOCK”, ijmhs, vol. 3, no. 4, Oct. 2013.
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Abstract

Background: Cardiovasculatory dysfunction occurs in surgical critically ill patients with shock. The degree of cardiovasculatory dysfunction in the Sequential Organ Failure Assessment (SOFA) score increases with higher catecholamine infusion rates. The aim of the present study was to compare the course of NT-proBNP plasma concentrations in surgical critically ill patients with non-septic or septic shock in association with catecholamine therapy.
Methods: In a prospective observational single-centre study in critically ill surgical patients admitted to an University adult ICU, 26 consecutive patients with non-septic shock and 18 patients with septic shock were longitudinally monitored before, during and after shock.
Results: During the stay on the ICU, NT-proBNP serum concentrations declined, remained stable or increased in both shock groups. The maximal NT-proBNP concentrations in patients with septic shock (median 4,429, range 193 to > 35,000 pg/ml) were higher than in those with non-septic shock (median 902, range 39 to > 31,937 pg/ml) (p = 0.037). NT-proBNP serum concentrations were higher in surviving patients with septic than with non-septic shock at > 0.1 and ï‚£ 1.0 ug/kg/min noradrenaline. In the non-survivors, NT-proBNP concentrations were always beyond the normal range in both groups.
Conclusions: Taken together, severity of cardiovascular dysfunction defined by higher dosage of catecholamines is associated with higher NT-proBNP concentrations in septic than in non-septic shock patients. In non-survivors of shock, NT-proBNP concentrations increase or remain elevated > 1000 pg/ml.

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