Ortega SMA, Membreño MJP, Poblano MM, Aguirre SJ, Martínez SJ

Language: Spanish
References: 15
Page: 66-73
PDF size: 100.77 Kb.

ABSTRACT

Background: Sepsis and septic shock are major causes of mortality and morbidity in the ICU. If inflammatory mediators responsible of sepsis remain elevated or if there is a poor cardiac function, septic myocardial dysfunction may occur, increasing morbidity and mortality. Brain natriuretic peptide (BNP) is an adequate biomarker for cardiac failure so our objective was to determine its utility in predicting myocardial dysfunction in septic patients.
Methods: Prospective study of all adult patients with sepsis and septic shock (as defined by the International Sepsis Definitions Conference) from January 2006 to March 2007. Demographics, APACHE II and SOFA score, lactate, SvO₂, hemodynamic parameters and BNP were divided in: Group A (BNP ‹ 500) and Group B (≥ 500 ng/dL). Results were analyzed with Student’s t-test.
Results: Of 37 patients analyzed (60% male), mean age was 61 ± 17, APACHE II 23 ± 6 and SOFA 11 ± 4 (with no statistic difference when divided in groups A and B). In Group A: 24 p (65% of all patients), Group B: 13 p (35%), SvO₂ 74 ± 91 vs 59 ± 8.97 (p = 0.004), PCP 17.25 ± 5.25 vs 23.25 ± 5.01 (p = 0.043), IC 4.13 ± 1.55 vs 2.88 ± 0.66 (p = 0.040), PVC 13.33 ± 5.56 vs 16.3 ± 4.99 (p = 0.17), ITVI 32.37 ± 13.7 vs 23.7 ± 6.53 (p = 0.128), FEVI 63.09 ± 8.53 vs 53.5 ± 8.52 (p = 0.035). Mortality was greater in Group B.
Conclusion: BNP ≥ 500 ng/dL is a predictor for myocardial abnormalities in septic patients helping to anticipate a higher mortality.

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