Jump to ContentJump to Main Navigation
Show Summary Details

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.


IMPACT FACTOR increased in 2015: 3.017
Rank 5 out of 30 in category Medical Laboratory Technology in the 2014 Thomson Reuters Journal Citation Report/Science Edition

SCImago Journal Rank (SJR) 2015: 0.873
Source Normalized Impact per Paper (SNIP) 2015: 0.982
Impact per Publication (IPP) 2015: 2.238

Online
ISSN
1437-4331
See all formats and pricing

 


Select Volume and Issue

Issues

What is the value of B-type natriuretic peptide testing for diagnosis, prognosis or monitoring of critically ill adult patients in intensive care?

Robert H. Christenson1

1Departments of Pathology and Medical and Research Technology, University of Maryland School of Medicine, Baltimore, MD, USA

Corresponding author: Dr. Robert H. Christenson, University of Maryland Medical Center, Rapid Response and Clinical Chemistry Laboratories, 22 South Greene Street, Baltimore, MD 21201, USA Phone: +1-410-328-8672, Fax: +1-410-328-5880,

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 46, Issue 11, Pages 1524–1532, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2008.294, October 2008

Publication History

Received:
2008-05-31
Accepted:
2008-07-24
Published Online:
2008-10-10

Abstract

Background: B-natriuretic peptide (BNP) and aminoterminal proBNP (NT-proBNP) are clinically useful for the diagnosis of decompensated heart failure and for prognosis in heart failure and acute coronary syndromes. Clinical use of these biomarkers in critically ill patients being treated in intensive care is not well established.

Methods: This is a narrative review of evidence identified searching MEDLINE with the strategy [(BNP OR NT-proBNP) AND (critical illness AND intensive care)]. Seven primary reports and two narrative reviews were retrieved. For completeness, literature from each of the following searches was reviewed: [(BNP OR NT-proBNP) AND (critical illness)] and [(BNP OR NT-proBNP) AND (intensive care)].

Results: Primary literature used BNP and NT-proBNP for diagnosis, prognosis and monitoring. For diagnosis of acute lung injury in unselected intensive care patients and for diagnosis of heart failure in trauma patients, the biomarkers had low sensitivity and are of modest use. BNP and NT-proBNP were found to have a significant ability to prognosticate adverse outcomes in critically ill patients. A single paper examined the use of BNP as a non-invasive replacement for pulmonary capillary wedge pressure, finding little value. The impact of renal insufficiency on the markers was noted as a confounder in most studies. In the secondary searches, some preliminary data suggested a possible role for the natriuretic peptides in exclusion of a cardiac cause for certain conditions among intensive care unit (ICU) patients. However, the general findings were that the performance of BNP and NT-proBNP is unimpressive among ICU patients.

Conclusions: Currently, utilization of BNP and NT-proBNP does not appear to provide much useful information or have a substantial role in the care of critically ill patients in intensive care.

Clin Chem Lab Med 2008;46:1524–32.

Keywords: aminoterminal proBNP (NT-proBNP); B-natriuretic peptide (BNP); critically ill; diagnosis; intensive care; monitoring; patients; prognosis; renal insufficiency

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Guniz M. Koksal, Yalm Dikmen, and Antonio M. Esquinas
Chest, 2015, Volume 147, Number 2, Page e63
[2]
Christopher King, Christopher W. May, Jeffrey Williams, and Oksana A. Shlobin
Critical Care Clinics, 2014, Volume 30, Number 3, Page 475
[3]
K. Somasundaram and J. Ball
Anaesthesia, 2013, Volume 68, Page 84
[4]
U. Janssens
Medizinische Klinik - Intensivmedizin und Notfallmedizin, 2012
[5]
M. OKKONEN, M. VARPULA, R. LINKO, J. PERTTILÄ, T. VARPULA, and V. PETTILÄ
Acta Anaesthesiologica Scandinavica, 2011, Volume 55, Number 6, Page 749
[6]
Thiane Gama Axelsson and Bengt Lindholm
Reviews in Clinical Gerontology, 2009, Volume 19, Number 02, Page 71

Comments (0)

Please log in or register to comment.